CAJ | 학술논문

目的评价胃癌根治切除并用温热重蒸馏水(Double Distilled Water, DDW)或DDW加醋酸洗必泰腹腔灌洗的疗效与适应证.方法在进行了43℃DDW对人胃癌细胞系MGC-803的杀伤效应与SY86B腹水瘤受抑制的研究基础上,将1986年1月～1995年12月施行胃癌根治切除术的500例病人分成3组.A组:根治术并用43℃DDW4000ml腹腔灌洗10min,共198例;B组:根治术并用DDW4000ml+醋酸洗必泰0.6g,腹腔灌洗4min,共89例;C组:根治术关腹前应用生理盐水4000ml,腹腔清洗4min,共213例.结果实验证明,应用43℃DDW对人胃癌细胞系MGC-803处理10min,或用0.015%醋酸洗必泰DDW处理4min,癌细胞可被杀灭.临床应用结果表明,A组与B组疗效相同,二者合在一起计算称灌洗组.各期病例术后1、3年生存率,3组间差异无显著意义;全组5年生存率,灌洗组为63.8%,对照组为51.2%.而且有效病例多为灌洗组的中期(Ⅱ、ⅢA)病例.结论胃癌根治术,关腹前采用本疗法行腹腔灌洗,对Ⅱ期、ⅢA期病例有良好效果.
목적평개위암근치절제병용온열중증류수(Double Distilled Water, DDW)혹DDW가작산세필태복강관세적료효여괄응증.방법재진행료43℃DDW대인위암세포계MGC-803적살상효응여SY86B복수류수억제적연구기출상,장1986년1월～1995년12월시행위암근치절제술적500례병인분성3조.A조:근치술병용43℃DDW4000ml복강관세10min,공198례;B조:근치술병용DDW4000ml+작산세필태0.6g,복강관세4min,공89례;C조:근치술관복전응용생리염수4000ml,복강청세4min,공213례.결과실험증명,응용43℃DDW대인위암세포계MGC-803처리10min,혹용0.015%작산세필태DDW처리4min,암세포가피살멸.림상응용결과표명,A조여B조료효상동,이자합재일기계산칭관세조.각기병례술후1、3년생존솔,3조간차이무현저의의;전조5년생존솔,관세조위63.8%,대조조위51.2%.이차유효병례다위관세조적중기(Ⅱ、ⅢA)병례.결론위암근치술,관복전채용본요법행복강관세,대Ⅱ기、ⅢA기병례유량호효과.
Objective To evaluate the effect and indications of radical gastrectomy combined with peritoneal lavage with thermal double distilled water (DDW) or DDW plus chlorhexidine acetate. Methods On the bases of the study on the killing effect of 43 ℃ DDW on human gastric cancer cell line MGC-803 and its inhibiting effect on ascitic tumor of SY86B mouse, 500 cases of gastric cancer who underwent radical gastrectomy from January 1986 to December 1995 were divided into three groups: group A (n=198) subject to radical gastrectomy and peritoneal lavage for 10 min with 4000 ml DDW at 43℃; group B (n=89) subject to radical gastrectomy and peritoneal lavage for 4 min with 4000 ml DDW plus 0.6g chlorhexidine acetate, and group C (n=213) subject to radical gastrectomy and peritoneal lavage for 4 min with 4000 ml normal saline at room temperature as control.Results Human gastric cancer cells MGC-803 could be completely killed by treatment of either 43 ℃ DDW for 10 min or DDW plus 0.015 ml/L chlorhexidine acetate for 4 min. Clinical trials proved that group A and group B (called lavage group as a whole) had almost the same curative effects. The 1-year survival rate and 3-year survival rate were similar in different stages among the groups. The 5-year survival rate was 63.8% in the lavage group and 51.2% in the control group respectively. Most of the cases with good effect were at the mid-stage (Ⅱ and ⅢA stage).Conclusion Radical gastrectomy combined with peritoneal lavage before closing the abdomen has satisfying effect on patients with gastric cancer at stage Ⅱ and stage ⅢA.