细胞减灭术联合腹腔内热灌注化疗治疗进展期结直肠癌及腹膜转移高风险的结直肠癌的短期疗效及安全性研究

发布时间：2018-01-25 01:08

  本文关键词： 结直肠癌 细胞减灭术 腹腔内热灌注化疗 安全性　出处：《浙江大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的： 探讨细胞减灭术(CRS)联合腹腔内热灌注化疗(HIPEC)在进展期结肠癌、腹膜转移高风险的结直肠癌治疗的短期疗效及安全性,以便为进展期结直肠癌及腹膜转移高风险的结直肠癌患者提供治疗依据。 方法： 根据入组条件选取自2014年4月至2015年3月于浙江大学附属第二医院进行腹腔热灌注化疗的进展期结肠癌、腹膜转移高风险的结直肠癌患者21例,观察患者的术后恢复情况、并发症情况及生活质量。 结果： 总纳入人数为21例,其中诊断为结直肠癌伴转移的有10例,结直肠癌术后复发转移癌有9例,腹膜转移高风险的结直肠癌的患者有2例,进展期患者术后住院时间多数集中于10天至15天之间,腹膜转移高风险的结直肠癌患者有1例小于10天,1例大于50天。21名患者发生Ⅲ度以上不良反应的有白蛋白降低1例,中性粒细胞降低1例,高胆红素血症1例,高血糖1例,低钙血症1例,血栓事件1例,胃肠道梗阻1例,吻合口瘘2例。Ⅲ度以上并发症总发生率为23.8%。所有患者住院期间未进行二次手术,无30天内非计划再入院,死亡率为零。12名患者术前和出院时生活质量有明显差异的有躯体功能(p=0.008)、角色功能(p=0.035)、口干(p=0.022),其余指标无明显差异。另外9名患者失访。 结论： 用CRS/HIPEC治疗进展期结直肠癌、有高危腹膜转移的结直肠癌并发症发生率不高、死亡率低,较为安全；患者短期生活质量会稍受影响,但仍可接受；目前认为开展CRS/HIPEC治疗进展期结直肠癌及腹膜转移高风险的结直肠癌具有较高的安全性和短期疗效,为CRS/HIPEC治疗此类患者提供了依据。
[Abstract]:Objective: Objective to investigate the short-term efficacy and safety of CRS combined with intraperitoneal hyperthermic infusion chemotherapy (HIPEC) in the treatment of colorectal cancer with high risk of advanced colon cancer and peritoneal metastasis. In order to provide evidence for the treatment of advanced colorectal cancer and high risk of peritoneal metastasis colorectal cancer patients. Methods: Patients with advanced colon cancer were selected from April 2014 to March 2015 in the second affiliated Hospital of Zhejiang University for intraperitoneal hyperthermic chemotherapy. The postoperative recovery, complications and quality of life were observed in 21 patients with high risk of peritoneal metastasis. Results: The total number of patients included was 21, of which 10 were diagnosed as colorectal cancer with metastasis, 9 with recurrence and metastasis after operation, and 2 with high risk of peritoneal metastasis. Postoperative hospitalization of advanced patients was mostly between 10 and 15 days, and one patient with high risk of peritoneal metastasis was less than 10 days. One patient with more than 50 days had more than 3 degree adverse reactions, including 1 case of decrease of albumin, 1 case of neutropenia, 1 case of hyperbilirubinemia, 1 case of hyperglycemia and 1 case of hypocalcemia. Thrombotic events occurred in 1 case, gastrointestinal obstruction in 1 case, anastomotic fistula in 2 cases. The total incidence of complications above grade 鈪，

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