腹腔热灌注联合静脉化疗治疗进展期右半结肠癌疗效观察  

Clinical efficacy of intraperitoneal thermal perfusion combined with intravenous chemotherapy in the treatment of advanced right colon cancer

作　　者：王帝 宋展[2] 钱国武[2] 张海洋[2] WANG Di;SONG Zhan;QIAN Guowu;ZHANG Haiyang(Department of Graduate,Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of General Surgery,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]新乡医学院研究生处,河南新乡453003 [2]南阳市中心医院普外科,河南南阳473000

出　　处：《新乡医学院学报》2023年第10期950-954,959,共6页Journal of Xinxiang Medical University

摘　　要：目的 探讨腹腔热灌注联合静脉化疗治疗进展期右半结肠癌的临床疗效。方法 选择2021年1月至2022年1月南阳市中心医院收治的进展期右半结肠癌患者70例为研究对象。随机将患者分为对照组(n=35)和观察组(n=35),对照组患者给予静脉化疗,观察组患者给予腹腔热灌注联合静脉化疗。分别于治疗前后采用流式细胞仪检测2组患者血清中CD3^(+)、CD4^(+)、CD8^(+)淋巴细胞占比,并计算CD4^(+)/CD8^(+)水平;比较2组患者治疗过程中不良反应发生率;采用生活质量测定量表评估2组患者治疗后的生活质量;比较2组患者随访1~2 a的预后情况。结果 治疗前,2组患者血清中CD3^(+)、CD4^(+)、CD8^(+)淋巴细胞占比及CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05)。2组患者治疗后血清中CD3^(+)、CD4^(+)淋巴细胞占比及CD4^(+)/CD8^(+)显著高于治疗前,CD8^(+)淋巴细胞占比显著低于治疗前(P<0.05)。治疗后,观察组患者血清中CD3^(+)、CD4^(+)淋巴细胞占比及CD4^(+)/CD8^(+)显著高于对照组,CD8^(+)淋巴细胞占比显著低于对照组(P<0.05)。对照组患者治疗过程中静脉炎、胃肠道反应、白细胞降低、肌酐轻度增高、肝功能异常发生率分别为17.1%(6/35)、20.0%(7/35)、14.3%(5/35)、11.4%(4/35)、11.4%(4/35),观察组患者治疗过程中静脉炎、胃肠道反应、白细胞降低、肌酐轻度增高、肝功能异常发生率分别为2.9%(1/35)、2.9%(1/35)、0.0%(0/35)、0.0%(0/35)、0.0%(0/35);对照组患者治疗过程中静脉炎、胃肠道反应、白细胞降低、肌酐轻度增高、肝功能异常等不良反应发生率均显著高于观察组(χ^(2)=11.202、14.420、15.401、12.089、12.089,P<0.05)。观察组患者的躯体功能、角色功能、情绪功能、社会功能评分均显著高于对照组(P<0.05)。对照组患者治疗后1、2 a生存率分别为54.3%(19/35)、22.9%(8/35),复发率分别为20.0%(7/35)、34.3%(12/35);观察组患者治疗后1、2 a生存率分别为97.1Objective To explore the clinical efficacy of intraperitoneal thermal perfusion combined with intravenous chemotherapy in the treatment of advanced right colon cancer.Methods A total of 70 patients with advanced right colon cancer admitted to Nanyang Central Hospital from January 2021 to January 2022 were selected as the research subjects and then they were randomly divided into the control group(n=35)and the observation group(n=35).The patients in the control group were treated with intravenous chemotherapy,the patients in the observation group were treated with intraperitoneal thermal perfusion combined with intravenous chemotherapy.The proportions of CD3^(+),CD4^(+),CD8^(+)lymphocytes in serum were detected by flow cytometry before and after treatment,and the ratio of CD4^(+)/CD8^(+)was calculated.The incidence of adverse reactions of patients during treatment was compared between the two groups.The quality of life of patients in the two groups after treatment was evaluated by quality of life questionnaire.All patients were followed up for 1-2 years and the prognosis of patients was compared between the two groups.Results There was no significant difference in the proportions of CD3^(+),CD4^(+),CD8^(+)lymphocytes in the serum and the ratio of CD4^(+)/CD8^(+)of patients between the two groups before treatment(P>0.05).The proportions of CD3^(+),CD4^(+)lymphocytes in the serum and the ratio of CD4^(+)/CD8^(+)of patients in two groups after treatment were significantly higher than those before treatment,while the proportion of CD8^(+)lymphocytes was significantly lower than that before treatment(P<0.05).After treatment,the proportions of CD3^(+),CD4^(+)lymphocytes in the serum and the ratio of CD4^(+)/CD8^(+)of patients in the observation group were significantly higher than those in the control group,while the proportion of CD8^(+)lymphocytes was significantly lower than that in the control group(P<0.05).The incidence of phlebitis,gastrointestinal reaction,decreased white blood cells,slight increase in creatinine

关 键 词：腹腔热灌注 静脉化疗 进展期右半结肠癌 

分 类 号：R735.3[医药卫生—肿瘤]