腹腔热灌注治疗恶性腹水的临床效果

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1、［摘要］目的比较常规腹腔化疗与腹腔热灌注化疗（HIPEC）的临床疗效差异，探讨HIPEC的临床应用价值与优势。方法将2015年1月〜2016年1月唐山市人民医院收治的86例患者依照治疗方式不同分为观察组（44例）及对照组（42例）。两组患者均采用常规腹膜腔穿刺方案将腹水放尽，观察组采用HIPEC疗法进行治疗，后使用四极板内生场热疗进行干预，对照组患者仅进行腹腔灌注治疗。记录HIPEC治疗时观察组患者不同时间点（治疗0、15、60min时）生命体征及温度变化情况；比较两组患者的临床疗效、Kamofsky评分变化情况、不良反

2、应情况。结果治疗过程中观察组患者生命体征及温度无明显变化（P〉0.05）。观察组患者临床疗效显著优于对照组（P0.05）,治疗后两组患者Kamofsky评分均较治疗前显著升高（P0.05），但观察组患者腹痛发生率显著高于对照组（P［关键词］腹腔化疗；腹腔热灌注化疗；恶性腹水;疗效［中图分类号］R735.7［文献标识码］A［文章编号］1673-7210(2016)08(b)-0110-05[Abstract]ObjectiveTocomparetheclinicaltherapeuticeffectofconvention

3、alintraperitonealchemotherapywithitraperitonealchemotherapyhyperthermic,andexploretheclinicalvalueandadvantagesofHIPEC.MethodsEighty-sixpatientsadmittedinthePeople’sHospitalofTangshanCityfromJanuary2015toJanuary2016weredividedintoobservationgroupandcontrolgroupac

4、cordingtothedifferenttreatment，and44casesweresetastheobservationgroup，42casesweresetasthecontrolgroup.Patientsofthetwogroupsweretreatedwithroutineperitonealcavitypuncturingschemeputtheascites，andtheobservationgroupwastreatedwithHIPECtherapy.Afterusingfourboardend

5、ogeneticfieldthermotherapyinintervention，patientsinthecontrolgroupwereonlytreatedwithintraperitonealperfusion；observationgroupweretreatedwithHIPEC.Changesoflifesignsandtemperatureatdifferenttimepoints(treatedfor0,15，60min)ofpatientsintheobservationgroupduringtheH

6、IPECtreatmentrecord.Theclinicalcurativeeffect，Karnofskyscorechanges，adversereactionswerecompared.ResultsInthecourseoftreatmentlifesignsandtemperatureofpatientsinobservationgrouphadnosignificantchanges(P>0.05).Theclinicalefficacyoftheobservationgroupwassignificant

7、lybetterthanthatofthecontrolgroup(P0.05).Aftertreatment，Karnofskyscoresofthetwogroupsweresignificantlyincreasedcomparedwithbeforetreatment(P0.05),buttheincidenceofabdominalpainoftheobservationgroupwassignificantlyhigherthanthatofthecontrolgroup(P［Keywords］Intrape

8、ritonealchemotherapy；Hyperthermicintraperitonealchemotherapy；Malignantascites；Curativeeffect腹腔或全身恶性肿瘤极易诱发腹腔脏壁层弥漫性病变，并进一步导致患者腹腔积液异常增多，临床上将其称为恶性腹水［1］。临床研究发现，恶性腹水