持续腹腔热灌注化疗治疗进展期胆管癌的临床疗效观察

发布时间：2018-04-12 19:05

本文选题：胆管肿瘤 + 进展期胆管癌　；参考：《第二军医大学学报》2017年05期

【摘要】：目的探讨持续腹腔热灌注化疗(CHPPC)治疗进展期胆管癌的临床疗效及对患者生存时间的影响。方法回顾性分析我院2014年8月至2016年6月收治的103例进展期胆管癌患者的临床资料,其中46例患者给予CHPPC治疗(CHPPC组),另57例给予常规静脉化疗(对照组)。比较两组患者的生活质量KPS评分、临床疗效、肝功能指标[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、γ-谷氨酰转移酶(γ-GT)、总胆红素(TB)、碱性磷酸酶(ALP)]和血清糖类抗原19-9(CA19-9)指标变化,以及不良反应发生情况。比较两组患者的生存时间。结果 CHPPC组的生活质量改善率为34.78%(16/46),高于对照组的19.30%(11/57,P0.05)。CHPPC组治疗有效率为67.39%(31/46),高于对照组的40.35%(23/57,P0.01)。CHPPC组的AST、ALT、γ-GT、TB、ALP及CA19-9中位数水平均低于对照组(P0.05)。CHPPC组白细胞减少、血小板减少及肝功能损伤发生率低于对照组(P0.05),两组血红蛋白减少、胃肠道反应和肾功能损伤的发生率差异无统计学意义(P0.05)。CHPPC组的生存时间为(12.00±2.47)个月,长于对照组的(6.00±0.80)个月(P0.01)。结论 CHPPC治疗进展期胆管癌临床疗效较常规静脉化疗显著,患者的血清CA19-9水平下降,肝功能及生活质量改善,生存时间延长,值得推广应用。
[Abstract]:Objective to investigate the clinical effect of continuous intraperitoneal hyperthermic infusion chemotherapy (CHPPC) in the treatment of advanced cholangiocarcinoma and its influence on the survival time of the patients.Methods the clinical data of 103 patients with advanced cholangiocarcinoma treated in our hospital from August 2014 to June 2016 were retrospectively analyzed. Among them, 46 cases were treated with CHPPC and 57 cases received routine intravenous chemotherapy (control group).The quality of life (KPS) score, clinical efficacy, liver function indexes [aspartate aminotransferase (alt), alanine aminotransferase (alt), 纬 -glutamyl transferase (纬 -GT) (total bilirubin), alkaline phosphatase (ALP)] and serum carbohydrate antigen (19-9CA19-9) were compared between the two groups.And the occurrence of adverse reactions.The survival time of the two groups was compared.The incidence of thrombocytopenia and liver function injury was lower than that of control group (P 0.05). There was no significant difference in the incidence of hemoglobin, gastrointestinal reaction and renal function injury between the two groups. The survival time of CHPPC group was 12.00 卤2.47 months, which was longer than that of control group (6.00 卤0.80) months (P0.01).Conclusion CHPPC is more effective than routine intravenous chemotherapy in the treatment of advanced cholangiocarcinoma. The level of serum CA19-9, the improvement of liver function and quality of life, and the prolongation of survival time in patients with advanced cholangiocarcinoma are worth popularizing.
【作者单位】：第二军医大学东方肝胆外科医院胆道三科;第二军医大学东方肝胆外科医院胆道一科;第二军医大学东方肝胆外科医院腹腔镜科;
【基金】：上海市科委科技创新行动计划(15411951900)~~
【分类号】：R735.8

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