目的 研究完整结肠系膜切除术(CME)联合雷替曲塞术中动脉灌注化疗治疗进展期结肠癌的效果.方法 将2013年3月至2014年1月粤北人民医院108例进展期结肠癌按治疗方式分为两组,观察组56例行CME联合雷替曲塞术中动脉灌注化疗,对照组5例接受传统结肠癌根治术,并行区域淋巴结清扫.手术后所有患者均使用FOLFOX4化疗方案8个疗程.结果 观察组患者术后腹盆腔感染发生率、切口感染发生率、吻合口瘘发生率、腹腔内出血发生率、粘连性肠梗阻发生率分别为8.92％、16.07％、1.78％、7.14％、12.5％,对照组分别为7.69％、19.13％、1.92％、5.76％、9.61％,差异均无统计学意义;观察组1年累计生存率为92.85％、3年累计生存率为71.42％,均明显优于对照组的86.5％、61.5％,差异均具有统计学意义(P<0.05).结论 CME联合雷替曲塞术中动脉灌注化疗治疗进展期直肠癌安全有效,可以显著改善患者预后.%Objective To study the effect of complete mesocolic excision (CME) combined with intraoperative arterial infusion chemotherapy with raltitrexed in treatment of advanced colorectal cancer. Methods A total of 108 pa-tients with advanced colorectal cancer in our hospital from March 2013 to January 2014 were randomly divided into two groups: observation group (n=56) and control group (n=52). The observation group underwent CME combined with pemetrexed for artery infusion chemotherapy during operation. The control group received traditional radical resection of colon cancer, and underwent regional lymph node dissection. After surgery, all patients were using FOLFOX4 chemo-therapy for 8 courses. Results The complication rates of the observation group and the control group showed no signifi-cant difference:postoperative abdominal and pelvic infection (8.92％vs 7.69％), wound infection (16.07％vs 19.13％), anastomotic leak (1.78％vs 1.92％), intra-abdominal hemorrhage (7.14％vs 5.76％), adhesive ileus (12.5％vs 9.61％), P>0.05. The 1-year cumulative survival rate (92.85％), 3-year cumulative survival rate (61.5％) of observation group were significantly better than 86.5％, 61.5％of the control group (P<0.05). Conclusion CME combined with intraoperative arterial infusion chemotherapy with raltitrexed in the treatment of advanced rectal cancer is safely effective, and it can significantly improve the prognosis of patients.
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