腹腔热灌注化学治疗在妇科恶性肿瘤腹腔镜下盆腔淋巴清扫术后的应用  

Application of intraperitoneal hyperthermic chemotherapy after laparoscopic pelvic lymphadenectomy for gynecological malignant tumors

作　　者：张宇[1] 李小毛[1] 廖文娟[1] 宋倩[1] 苏淑军[1] 

机构地区：[1]中山大学附属第三医院妇科,广州510630

出　　处：《新医学》2017年第11期800-803,共4页Journal of New Medicine

基　　金：广州市科学研究专项(201607010085)

摘　　要：目的探讨在早期妇科恶性肿瘤患者行腹腔镜下盆腔淋巴清扫术后预防性应用腹腔热灌注化学治疗(HIPEC)的可行性和安全性。方法选择64例早期妇科恶性肿瘤患者,在腹腔镜下行盆腔淋巴清扫术后预防性应用HIPEC,分析HIPEC后的腹腔灌洗液细胞学检查结果和HIPEC的相关不良反应及并发症。结果 64例患者均顺利完成腹腔热灌注化学治疗,29例患者腹腔灌注液细胞学检查均未见确切癌细胞,查出退变坏死的核异质细胞8例(27.6%),正常56例(72.4%)。HIPEC后出现发热4例(6.3%)、恶心呕吐4例(6.3%)、腹痛腹胀6例(9.4%)、血尿1例(1.6%)、下肢麻木8例(12.5%)、血栓6例(9.4%)、盆腔感染2例(3.1%)、伤口愈合不良1例(1.6%)及骨髓抑制3例(4.7%),所有患者均无出现肝、肾功能异常或肠梗阻。结论早期妇科恶性肿瘤患者行腹腔镜下盆腔淋巴清扫术后立即进行预防性HIPEC是可行的。Objective To investigate the feasibility and safety of hyperthermic intraperitoneal chemo-therapy （HIPEC） in patients with early gynecological malignant tumors after laparoscopic pelvic lymphadenec-tomy. Methods Sixty-four patients with early gynecological malignant carcinomas undergoing HIPEC afterlaparoscopic pelvic lymphadenectomy were recruited in this study. Cytological results of the adverse events and complications after HIPECwere analyzed. Results All 64 patients successfully receivedHIPEC. 29 patients had no definite cancer cells in the cytology of peritoneal perfusion fluid. Degenerative and necrotic dyskaryotic cells were found in peritoneal lavage fluid of 8 cases（27. 6% ）. The normal rate of cytolog-ical examination of the peritoneal lavage was 72. 4%. After HIPEC, fever occurred in 4 cases （6. 3% ） , nau-sea and vomiting in 4 （6. 3% ） , abdominal pain and distension in 6 （9. 4% ） , hematuria in 1 （1. 6% ）, numbness of the lower extremities in 8 （12. 5% ）,thrombosis in 6 （9. 4% ）,pelvic infection in 2 （ 3poor wound healing in 1 （1. 6% ） and bone marrow suppression in 3 （4. 7% ）. Neither liver and kidney dys-function nor intestinal obstruction was observed. Conclusion It is feasible and safe to deliver preventiveHIPEC for women with early gynecological malignant tumors immediately after laparoscopic pelvic lymphadenec- tomy.

关 键 词：腹腔热灌注化学治疗 宫颈癌 子宫内膜癌 腹腔镜手术 

分 类 号：R737.3[医药卫生—肿瘤]