胃肠道恶性肿瘤根治术后腹腔化疗的方法

摘要

Objective　To study intraperitoneal chemotherapy methods for patients with gastrointestinal cancer following radical operation and relative side effects. Methods　The chemotherapy regiments were injected into adbominal cavity with 2 000～3 000ml infection solution eachcycle through three methods named as direct injection, abdominal conduit dropping and abdominal pump dropping. The selected medicines including 5-Fu, CF, HCPT, PDD, VP-16 were combines as follows: 1) 5-Fu, CF and HCPT; 2) 5-Fu, CF and PDD; 3) 5-Fu, CF and VP-16 with the doses of 5-Fu being 2.5 to 3.0g/cycle, CF 100 to 150mg/day, HCPT 40 to 50 mg cycle, PDD 100mg and VP-16 300 to 500mg/cycle respectively. Results　The three chemotherapy methods had advantages and disadvantages respectively. Abdominal distention (100%) and abdominal pain (14.9%) were the most side effects of intraperitoneal chemotherapy. The side effects of chemotherany agents included nausea, vomiting, leukopenia, liver function damage, diarrhea and alopecia. But they were slight. Conclusions　The three methods were useful for intraperitoneal chemotherapy.%目的　探讨胃肠道的恶性肿瘤根治术后腹腔化疗方法及其相关副作用。方法　应用直接注入法、腹腔置管法、腹腔置泵法三种手段进行腹腔化疗， 选用的药物是： 5-Fu、 CF、 HCPT、 PDD、 VP-16等联合化疗药物组合有三种： (1) 5-Fu、CF、HCPT；(2) 5-Fu、CF、PDD； (3) 5-Fu、CF、VP-16。化疗剂量与每一静脉化疗周期量相同， 即： 5+Fu 2.5～3.0 g/周期； CF 100～150 mg/天(使用5-Fu当天前2～4小时应用)； HCPT 40～50 mg/周期； PDD 100 mg/周期; VP-16 300～500 mg/周期； 输入腹腔的液体量在2　500～3　000　ml。结果　三种腹腔化疗方法各有优缺点， 以腹腔置管法应用最为常用， 腹腔化疗方法本身引起的主要副作用是腹胀(100%)、腹痛(14.9%)、肠损伤、肠麻痹、腹膜炎偶有发生； 腹腔化疗药物引起的反应有恶心、呕吐、白细胞下降、肝功损伤、腹泻、脱发等， 但程度不重。结论　直接注入法、腹腔置管法、腹腔置泵法是值得推广的腹腔化疗方法。