發(fā)布時間：2018-01-25 01:08

  本文關(guān)鍵詞： 結(jié)直腸癌 細(xì)胞減滅術(shù) 腹腔內(nèi)熱灌注化療 安全性　出處：《浙江大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 探討細(xì)胞減滅術(shù)(CRS)聯(lián)合腹腔內(nèi)熱灌注化療(HIPEC)在進(jìn)展期結(jié)腸癌、腹膜轉(zhuǎn)移高風(fēng)險的結(jié)直腸癌治療的短期療效及安全性,以便為進(jìn)展期結(jié)直腸癌及腹膜轉(zhuǎn)移高風(fēng)險的結(jié)直腸癌患者提供治療依據(jù)。 方法： 根據(jù)入組條件選取自2014年4月至2015年3月于浙江大學(xué)附屬第二醫(yī)院進(jìn)行腹腔熱灌注化療的進(jìn)展期結(jié)腸癌、腹膜轉(zhuǎn)移高風(fēng)險的結(jié)直腸癌患者21例,觀察患者的術(shù)后恢復(fù)情況、并發(fā)癥情況及生活質(zhì)量。 結(jié)果： 總納入人數(shù)為21例,其中診斷為結(jié)直腸癌伴轉(zhuǎn)移的有10例,結(jié)直腸癌術(shù)后復(fù)發(fā)轉(zhuǎn)移癌有9例,腹膜轉(zhuǎn)移高風(fēng)險的結(jié)直腸癌的患者有2例,進(jìn)展期患者術(shù)后住院時間多數(shù)集中于10天至15天之間,腹膜轉(zhuǎn)移高風(fēng)險的結(jié)直腸癌患者有1例小于10天,1例大于50天。21名患者發(fā)生Ⅲ度以上不良反應(yīng)的有白蛋白降低1例,中性粒細(xì)胞降低1例,高膽紅素血癥1例,高血糖1例,低鈣血癥1例,血栓事件1例,胃腸道梗阻1例,吻合口瘺2例。Ⅲ度以上并發(fā)癥總發(fā)生率為23.8%。所有患者住院期間未進(jìn)行二次手術(shù),無30天內(nèi)非計劃再入院,死亡率為零。12名患者術(shù)前和出院時生活質(zhì)量有明顯差異的有軀體功能(p=0.008)、角色功能(p=0.035)、口干(p=0.022),其余指標(biāo)無明顯差異。另外9名患者失訪。 結(jié)論： 用CRS/HIPEC治療進(jìn)展期結(jié)直腸癌、有高危腹膜轉(zhuǎn)移的結(jié)直腸癌并發(fā)癥發(fā)生率不高、死亡率低,較為安全；患者短期生活質(zhì)量會稍受影響,但仍可接受；目前認(rèn)為開展CRS/HIPEC治療進(jìn)展期結(jié)直腸癌及腹膜轉(zhuǎn)移高風(fēng)險的結(jié)直腸癌具有較高的安全性和短期療效,為CRS/HIPEC治療此類患者提供了依據(jù)。
[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，

本文編號：1461555