腹腔热灌注化疗对结肠癌患者围手术期肾功能的影响  

Effect of IHPC on perioperative period of renal function in patients with colon cancer

作　　者：张焕虎 宫庆[1] 韩传吉[1] 战志勇[1] 

机构地区：[1]威海市立医院胃肠外科,山东威海264200

出　　处：《中华肿瘤防治杂志》2016年第6期400-402,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的腹腔热灌注化疗（intraperitoneal hyperthermic perfusion chemotherapy，IHPC）已成为继手术、传统化疗和放疗等后一种有效的肿瘤治疗方法，本研究探讨IHPC对患者肾功能的影响，为患者治疗过程中肾功能的变化提供参考依据。方法2012-04—01—2013—04—01威海市立医院胃肠外科收治结肠癌患者113例，按照治疗方式分成2组，A组58例，均完成手术后给予常规术后恢复治疗；B组55例，除给予常规术后恢复治疗外，于术后6h内完成IHPC，治疗条件：43。C，60min，300～500mL／min，灌注生理盐水3500～4500mL，灌注顺铂60mg、5-氟尿嘧啶（5-fluorouracil，5-FU）1g。监测患者术后24、72h以及1周的肾功能及24h尿量变化。结果B组术后24h尿量为（1162±93）mL，较A组的（1536±78）mL明显减少，差异有统计学意义，t=23．21，P〈0．001；术后72h（t=1．49，P=0．138）及1周（t=0．90，P=0．372）差异无统计学意义。B组术后24h的尿素氮（blood urea nitrogen，BUN）为（7．8±3．2）mmol／L，与A组的（6．4±1．6）mmol／L相比差异有统计学意义，t=2．96，P〈0．05；术后72h（t=1．51，P=0．135）及1周（t=0．52，P=0．606）差异无统计学意义。B组术后24h的肌酐（serum creatinine，SCr）为（108±7．2）μmol／L，较A组的（92±5．4）μmol／L明显升高，差异有统计学意义，t=13．41，P〈0．001；术后72h（t=1.53，P=0．129）及1周（t=0．87，P=0．386）差异无统计学意义。结论腹腔热灌注化疗早期可影响患者肾功能，但经过不予处理或对症治疗后可恢复，是一种安全的结肠癌辅助治疗方法。OBJECTIVE To discuss the effect of IHPC on renal function in patients with colon cancer to provide evidence for treatment. METHODS A total of 113patients with colon cancer between April 2012 and April 2013 were randomly divided into two groups： Conventional treatment of postoperative recovery group （group A, n=58） and IHPC besides conventional treatment of postoperative recovery group （group B, n= 55）. The treatments of IHPC were completed in six hours after operations （treatment temperature 43 ℃, 60 minutes, the infusion rate 300- 500 mL/min, saline 3 500-4 500 mL, Cisplatin 60 mg, 5-FU 1 g）. The renal function and changes in urine output of patients were monitored after 24 h, 72 h and 1 week. RESULTS The patients of group B 24 hours after operation had a transient decreased urine output （1 162±93） mL compared with the group A （1 536±78） mL（t=23.21,P〈0. 001）,but the difference between two groups had no statistical significance after 72 hours （ t = 1.49, P = 0.138） and one week （t = 0.90, P = 0.372 ） after operation. BUN（t=2.96,P〈0.05） and CREA （t=13.41 ,P〈0. 001） of group B were both higher than those of group A 24 hours after operation. And there were no statistical differences after 72 hours（tscr = 1.53,P=0. 129; t BUN = 1. 51, P= 0. 135） and one week t SCr=0.87,P=0. 386;t BUN =0. 52,P=0. 606） after operation. CONCLUSION IHPC can affect renal function early after the treatment which will recover with or without therapy and is a safe mean to tumor treatment for patients with colon cancer.

关 键 词：腹腔热灌注治疗 结肠癌 肾功能 药物疗法 联合 

分 类 号：R735.35[医药卫生—肿瘤]