首页|用术中腹腔灌注雷替曲塞法治疗结直肠癌患者的临床研究

用术中腹腔灌注雷替曲塞法治疗结直肠癌患者的临床研究

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目的 研究术中腹腔灌注雷替曲塞在结直肠癌患者中的应用效果.方法 回顾性分析结直肠癌患者临床资料,根据治疗方法按照队列法分为对照组和试验组.2组均用五孔法进行腹腔镜结直肠癌根治术,对照组关腹前用温热0.9%NaCl 2 000 mL冲洗腹腔;试验组在对照组基础上,将0.9%NaCl 500 mL+雷替曲塞4 mg热灌注入腹腔.比较2组患者术前和术后肿瘤指标、肝肾功能、术后恢复情况、并发症及术后1年生存情况.结果 对照组和试验组各入组40例.术后化疗时,试验组和对照组的癌胚抗原(CEA)分别为(9.50±2.17)和(11.47±2.06)μg·L-1,糖类抗原 199(CA199)分别为(127.25±9.31)和(182.64±10.39)U·L-1,在统计学上差异均有统计学意义(均P<0.05).试验组术前、术后1 d时谷丙转氨酶(GPT)分别为(17.12±4.57)和(21.33±5.42)U·L-1,谷草转氨酶(GOT)水平分别为(17.03±3.54)和(19.15±4.28)U·L-1,在统计学上差异均有统计学意义(均P<0.05).2组患者术后肠功能恢复时间、住院时间及并发症发生率比较,在统计学上差异均无统计学意义(均P>0.05).术后1年,试验组和对照组的无疾病进展生存期分别为(7.49±0.98)和(7.01±0.95)个月,在统计学上差异有统计学意义(P<0.05);但2组患者的总生存期比较,在统计学上差异无统计学意义(P>0.05).结论 术中腹腔灌注雷替曲塞可有效降低结直肠癌患者肿瘤标志物水平,延缓疾病进展,但会引起GPT、GOT可逆性升高.
Clinical trial of intraoperative intraperitoneal perfusion of raltitrexed in patients with colorectal cancer
Objective To explore the application effect of intraoperative intraperitoneal perfusion of raltitrexed in patients with colorectal cancer.Methods The clinical data of patients with colorectal cancer were retrospectively analyzed.According to different treatment using cohort methods,patients were divided into control group and treatment group.Both groups underwent five-hole laparoscopic radical resection of colorectal cancer.The control group was given intraperitoneal irrigation of warm 0.9%NaCl 2 000 mL before abdominal closure.On the basis of control group,treatment group was given intraperitoneal perfusion of 0.9%NaCl 500 mL+raltitrexed 4 mg.The tumor indexes and liver-kidney function before and after surgery,postoperative recovery,complications and survival at 1 year after surgery were compared between the two groups.Results There were 40 cases in control group and 40 cases in treatment group.During postoperative chemotherapy,levels of carcinoembryonic antigen(CEA)in treatment group and control group were(9.50±2.17)and(11.47±2.06)μg·L-1,and levels of carbohydrate antigen 199(CA199)were(127.25±9.31)and(182.64±10.39)U·L-1,and the differences were statistically significant(P<0.05).Before and at 1 d after surgery,glutamic-pyruvic transaminase(GPT)levels in treatment group were(17.12±4.57)and(21.33±5.42)U·L-1,and glutamic-oxaloacetic transaminase(GOT)levels were(17.03±3.54)and(19.15±4.28)U·L-1,and the differences were statistically significant(P<0.05).There was no significant difference in postoperative recovery time of intestinal function,hospitalization time or incidence of complications between the two groups(P>0.05).At 1 year after surgery,disease-free survival in treatment group and control group were(7.49±0.98)months and(7.01±0.95)months,and the differences was statistically significant(P<0.05).There was no significant difference in overall survival between the two groups(P>0.05).Conclusion Intraoperative intraperitoneal perfusion of raltitrexed can effectively reduce levels of tumor markers and delay disease progression in patients with colorectal cancer.However,it will cause the reversible increase of GPT and GOT.

raltitrexedcolorectal cancerlaparoscopic radical resection of colorectal cancerintraperitoneal heat per-fusion

肖家全、张勇

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马鞍山市人民医院 胃肠外科,安徽马鞍山 243000

雷替曲塞 结直肠癌 腹腔镜结直肠癌根治术 腹腔热灌注

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(6)
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