鸦胆子油乳联合顺铂持续循环腹腔热灌注治疗恶性腹水的临床研究.pdf

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1、232逍丝艘瘦苤查(皇王题)!Q12生!!旦筮!鲞箜!塑』旦塘Q!型(垦!!!!塑!适Y!垡i!!)，坠!!!堕些!!!!!：y!!垒，丛!：璺·论著·鸦胆子油乳联合顺铂持续循环腹腔热灌注治疗恶性腹水的临床研究牟洪超董立军【摘要】目的探讨鸦胆子油乳联合顺铂持续循环腹腔热灌注治疗恶性腹水的近期疗效，并分析其不良反应及相关并发症。方法27例恶性腹水患者通过超声引导下、开腹及腹腔镜辅助下腹腔置管，先行持续腹腔热灌注治疗(生理盐水2，000ml+顺铂50mg／m：)4次，于末次灌注化疗结束后排净灌洗液．经导管注入43℃生理盐水100lIl

2、l+地塞米松15mg+鸦胆油乳100ml后拔管。评估鸦胆子油乳联合顺铂持续循环腹腔热灌注对恶性腹水的临床疗效及安全性。结果本组27例恶性腹水患者治疗后，腹胀症状明显改善，超声检查腹水显著减少。治疗组中完全缓解者18例，部分缓解者7例，稳定者2例，总体有效率高达92．6％(25／27)。治疗过程中无III或IV级严重毒副反应，无肠粘连和肠梗阻等治疗相关并发症发生。结论鸦胆子油乳联合顺铂持续循环腹腔热灌注治疗恶性腹水．安全、微创、不良反应少而轻、近期疗效明显。【关键词】循环热灌注；鸦胆子油乳；顺铂；恶性腹水Clinicaleffica

3、cyofcisplatinhyperthermicintraperitonealperfusionchemotherapycombined、以mbruceajavanicaoilemulsionformalignantascitesMUHong-chao，DONGLi-jun．DepartmentofHepatobillarySurgery，the404Ho印hdofPeople'sLiberationArmy，Weihai264200，Chinaco肿spo蒯ingauthor：MUHong-chao，E—mail：157062

4、445@qq．con【Abstract】ObjectiveToinvestigatetheeffectandsafetyofeisplatinhyperthermicintraperitonealperfusionchemotherapy(HIPC)combinedwithbmceajavanicaoilemulsionformalignantascites．MethodsTwenty-sevenpatientswithmalignantascitesfirstreceivedfourcyclesofcontinuousHIPC(

5、saline2000ml+cisplatin50mg／m2)，thenamixtureof100mlsaline，15mgdexamethasoneand100mlbruceajavanicaoilemulsionwasinjectedintotheabdominalcavityafterthelasttreatmemofHIPEC．Theclinicalefficacyandsafetywereassessed．ResultsAfterHIPCcombinedwithbmeeajavanicaoilemulsion，thesub

6、jectivesymptomsuchasabdominaldistensionwasalleviated，andobjectiveindexesincludingtheabdominalcircumferenceandvolumeofmalignantasciteswerereducedsignificantlyinall27patients．Thecompleteresponse(CR)wasobservedin18cases(66．7％)，partialresponse(PR)in7cases(25．9％)，stabledis

7、ease(SD)in2cases(7．4％)，andnocasedevelopedprogressivedisease(PD)．Thetotalresponseratereached92％(25／27)．Therewerenoserious(mor1Vgrade)adverseeventsofchemotherapy．andnoHIPC．relatedcomplicationssuchasintestinaladIhesionandobstructionduringthetreatmentperiod．ConclusionCisp

8、latinHIPCcombinedwithbruceajavanicaoilemulsionformalignantasciteswassafeandeffective，withlessadverseeventsofchemotherapyandH