根治术切除联合腹腔热灌注化疗治疗局部进展期胃癌患者的安全性分析  

Safety analysis of radical resection combined with intraperitoneal hyperthermic perfusion chemotherapy in the treatment of patients with locally advanced gastric cancer

作　　者：陈铁[1] 江晓晖[1] 吴金东[1] 张学良[1] 王鼎[1] 李阳成 CHEN Tie;JIANG Xiaohui;WU Jindong;ZHANG Xueliang;WANG Ding;LI Yangcheng(Department of Gastrointestinal Surgery,Nantong Tumor Hospital,Jiangsu Nantong 226361,China.)

机构地区：[1]南通市肿瘤医院胃肠外科,江苏南通226361

出　　处：《现代肿瘤医学》2023年第5期869-874,共6页Journal of Modern Oncology

摘　　要：目的:探讨根治术切除联合腹腔热灌注化疗治疗局部进展期胃癌患者的安全性分析。方法:选择2019年01月至2021年12月在我院接受D2根治术联合HIPEC治疗的局部进展期胃癌患者146例的临床数据资料进行回顾性分析。描述全部患者在围手术期不良反应事件的发生情况。分析接受D2根治术联合HIPEC治疗的局部进展期胃癌患者围手术期安全性的影响因素。结果:146例患者之中,共有64例患者(43.84%)在围手术期之内出现81例次不同程度的不良反应事件,其中以低白蛋白血症和贫血的数量最多,分布为32例(39.51%),21例(25.93%)。全部不良反应事件分级中,以1级的数量最多,共55例(37.67%)。全部不良反应事件患者均经过对症治疗后缓解,未对后续治疗构成影响。单因素分析结果中,年龄、神经侵犯情况不同的患者的围手术期不良反应事件分级的数据差异具有统计学意义(P<0.05)。年龄大于60岁(β’=0.651)、肿瘤发生神经侵犯(β’=0.183)的患者在围手术期具有更高的不良反应事件分级(P<0.05)。结论:局部进展期胃癌患者在接受D2根治术联合HIPEC治疗后的围手术期内具有一定的不良反应风险,但各项不良反应事件的发生率尚在可接受范围之内,手术医师对于年龄高于60岁以及肿瘤侵犯神经的患者需要给予重点关注。Objective:To investigate the safety of intraperitoneal hyperthermic perfusion chemotherapy in patients with locally advanced gastric cancer after radical resection.Methods:The clinical data of 146 patients with locally advanced gastric cancer who underwent D2 radical surgery combined with HIPEC in a hospital from January 2019 to December 2021 were retrospectively analyzed.Describe the occurrence of perioperative adverse events in all patients.To analyze the influencing factors of perioperative safety in patients with locally advanced gastric cancer who received D2 radical surgery combined with HIPEC.Results:Among the 146 patients, a total of 64 patients(43.84%) had 81 adverse events of varying degrees during the perioperative period, of which the number of hypoalbuminemia and anemia was the largest, with 32 cases(39.51%) and 21 cases(25.93%).Among all the adverse events, the number of grade 1 was the largest, with a total of 55 cases(37.67%).All patients with adverse events were relieved after symptomatic treatment, which did not affect the follow-up treatment.In the results of univariate analysis, there were statistically significant differences in the classification of perioperative adverse events among patients with different age and neurological invasion(P<0.05).Older than 60 years old(β’=0.651),nerve invasion of tumor(β’=0.183) patients had higher adverse event grades during perioperative period(P<0.05).Conclusion:Patients with locally advanced gastric cancer have a certain risk of adverse reactions during the perioperative period after receiving D2 radical surgery combined with HIPEC,but the incidence of various adverse reactions is still within the acceptable range.Surgeons should pay special attention to patients older than 60 years old and patients with tumor invading nerves.

关 键 词：腹腔热灌注化疗 胃癌 根治术 安全性 淋巴结清扫 神经侵犯 

分 类 号：R735.2[医药卫生—肿瘤]