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目的探讨进展期胃癌术中实施腹腔热灌注化疗的临床效果。方法 19例进展期胃癌患者作为观察组(手术联合腹腔热灌注化疗),选择同期此类患者20例作为对照组(单纯手术治疗),观察两组术后并发症、死亡、术后腹膜转移发生情况,比较两组患者1年生存率和2年生存率。结果观察组患者随访过程中共死亡4例(2例患者因腹腔广泛转移死亡、1例患者因肝转移死亡、1例患者因肾转移死亡)。对照组患者死亡7例(3例因腹膜广泛转移死亡、2例因肝脏转移死亡、其余2例因肺转移死亡)。观察组患者术后发生吻合口瘘0例、出血1例、伤口感染1例;对照组患者术后发生吻合口瘘0例、出血0例、伤口感染1例;观察组患者1年生存18例,2年生存14例;对照组患者1年生存16例,2年生存12例。观察组的1年和2年生存率分别高于对照组,差异有统计学意义(P<0.05)。结论进展期胃癌术中实施腹腔热灌注化疗的临床效果显著,值得借鉴。
Objective To investigate the clinical effect of intraperitoneal hyperthermic perfusion chemotherapy in advanced gastric cancer. Methods Twenty-nine patients with advanced gastric cancer were treated as observation group (operation combined with intraperitoneal hyperthermic perfusion chemotherapy). Twenty patients of the same type were selected as the control group (surgery alone). Postoperative complications, death and postoperative peritoneal metastasis were observed One-year and two-year survival rates were compared between the two groups. Results In the observation group, 4 patients died during the follow-up (2 patients died of extensive peritoneal metastasis, 1 patient died of liver metastasis, and 1 patient died of kidney metastasis). Seven patients died in the control group (3 died of extensive peritoneal metastases, 2 died of liver metastases and 2 died of lung metastases). In the observation group, there were 0 anastomotic fistula, 1 bleeding and 1 wound infection after operation. In the control group, 0 anastomotic fistula, 0 hemorrhage and 1 wound infection occurred in the control group. The 1-year survival rate in the observation group was 18 , 2 years survival in 14 cases; control group patients 1 year survival in 16 cases, 2 years of survival in 12 cases. The 1-year and 2-year survival rates of the observation group were higher than those of the control group respectively, with significant difference (P <0.05). Conclusion Intraperitoneal intraperitoneal hyperthermic perfusion chemotherapy has a significant clinical effect in advanced gastric cancer and is worth learning from.