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[目的]探讨区域性缓释化疗在消化道恶性肿瘤中的疗效。[方法]68例胃肠肿瘤患者随机分为两组:治疗组38例,术中使用植入缓释氟尿嘧啶;对照组30例,术中未使用缓释氟尿嘧啶。两组临床病理资料具有可比性。[结果]使用植入缓释氟尿嘧啶治疗组未出现明显的胃肠道反应。治疗组吻合口瘘1例、肠梗阻1例、腹腔化脓性感染1例;而对照组吻合口瘘1例、肠梗阻1例、无腹腔化脓性感染。两组并发症发生率比较无统计学差异(7.9%vs 6.7%,χ2=0.037,P=0.847)。治疗组2年局部复发率为5.3%,而对照组2年局部复发率为23.3%(χ2=0.060,P=0.027);两组2年无远处转移率无统计学差异(χ2=0.060,P=0.807)。治疗组与对照组术后2年生存率分别为94.7%和76.7%(P<0.05)。[结论]术中植入缓释氟尿嘧啶安全、可行,可降低胃肠肿瘤术后复发率及提高术后生存率,具有一定的临床应用价值。
[Objective] To investigate the efficacy of regional sustained-release chemotherapy in gastrointestinal malignancies. [Method] 68 patients with gastrointestinal tumors were randomly divided into two groups: the treatment group of 38 cases, the use of intraoperative implantation of sustained-release fluorouracil; control group of 30 patients, no intraoperative use of sustained-release fluorouracil. Two sets of clinical and pathological data are comparable. [Results] There was no obvious gastrointestinal reaction in the group treated with sustained-release fluorouracil. One case of anastomotic fistula, one case of intestinal obstruction and one case of intraperitoneal purulent infection were treated in the treatment group. One case of anastomotic fistula and one case of intestinal obstruction in the control group had no intraperitoneal suppurative infection. There was no significant difference in the complication rates between the two groups (7.9% vs 6.7%, χ2 = 0.037, P = 0.847). The 2-year local recurrence rate was 5.3% in the treatment group and 23.3% in the control group at 2 years (χ2 = 0.060, P = 0.027). There was no significant difference in the 2-year distant metastasis rate between the two groups (χ2 = 0.060, P = 0.807). The 2-year postoperative survival rates in the treatment group and the control group were 94.7% and 76.7%, respectively (P <0.05). [Conclusion] The intraoperative implantation of sustained-release fluorouracil is safe and feasible, which can reduce the postoperative recurrence rate and increase the postoperative survival rate of gastrointestinal tumors, and has certain clinical value.