CAJ | 학술논문

背景:如何寻找更好的药物剂型、给药途径,使高浓度的药物直接作用于局部,并提高药物对局部靶组织的选择性、延长药物作用时间,对预防乳腺癌局部复发有重要意义.目的:探索在乳腺癌改良根治术中应用氟尿嘧啶植入剂的临床安全性,探寻预防乳腺癌局部复发的新途径.方法:63例乳腺癌改良根治术患者,TNM分期:Ⅰ+Ⅱ期35例,Ⅲ期28例,随机分为植入剂组32例及对照组31例,植入剂组在肿瘤下方,腋窝、锁骨下血管区域、胸大小肌之间多点喷撒氟尿嘧啶植入剂,总剂量为600 mg,每点处小于100 mg,观察应用植入剂后,切口有无感染裂开,8 d后的皮下积液情况,皮瓣坏死、患肢水肿、拆线天数及血红、白细胞、肝肾功能情况.结果与结论:植入剂组与对照组在切口感染裂开、皮下积液量、患肢水肿、拆线天数及血红细胞计数等方面差异无显著性意义(P>0.05),两组治疗后,血白细胞计数、谷丙转氨酶、肌酐均较治疗前有明显增加(P<0.05),但是两组之间差异无显著性意义(P>0.05).结果提示乳腺癌改良根治术中应用氟尿嘧啶植入剂是安全可靠的,是乳腺癌术后局部化疗的有效途径.
배경:여하심조경호적약물제형、급약도경,사고농도적약물직접작용우국부,병제고약물대국부파조직적선택성、연장약물작용시간,대예방유선암국부복발유중요의의.목적:탐색재유선암개량근치술중응용불뇨밀정식입제적림상안전성,탐심예방유선암국부복발적신도경.방법:63례유선암개량근치술환자,TNM분기:Ⅰ+Ⅱ기35례,Ⅲ기28례,수궤분위식입제조32례급대조조31례,식입제조재종류하방,액와、쇄골하혈관구역、흉대소기지간다점분살불뇨밀정식입제,총제량위600 mg,매점처소우100 mg,관찰응용식입제후,절구유무감염렬개,8 d후적피하적액정황,피판배사、환지수종、탁선천수급혈홍、백세포、간신공능정황.결과여결론:식입제조여대조조재절구감염렬개、피하적액량、환지수종、탁선천수급혈홍세포계수등방면차이무현저성의의(P>0.05),량조치료후,혈백세포계수、곡병전안매、기항균교치료전유명현증가(P<0.05),단시량조지간차이무현저성의의(P>0.05).결과제시유선암개량근치술중응용불뇨밀정식입제시안전가고적,시유선암술후국부화료적유효도경.
BACKGROUND: It is of significance for looking for ideal pharmaceutical dosage form and administration route to make sure direct action in local region, improve selection of high-concentration drug to local target tissue, prolong drug action, and prevent local recurrence of breast cancer. OBJECTIVE: To explore the clinical safety of fluorouracil implants for modified radical mastectomy, and investigate the new way to prevent the local recurrence of breast cancer. METHODS: A total of 63 cases with breast cancer treated by modified radical mastectomy in TNM stage of Ⅰ + Ⅱ (n=35) and Ⅲ(n=28) were randomly divided into control group (n=31) and implant group (n=32). Fluorouracil implants (600 mg in total, less than 100 mg at each site) were multiple-implanted below the tumor and in the armpits, subclavian vascular region, and axillary vascular area, so as to observe the incision infection or dehiscence, the subcutaneous fluid volume after 8 days, flap necrosis, limb edema, stitches days, WBC, RBC, hepatic and renal function. RESULTS AND CONCLUSION: The differences in the incision infection or dehiscence, the subcutaneous fluid volume after 5 days, flap necrosis, limb edema, stitches days, and RBC between two groups were not significantly. Levels of WBC, glutamic-pyruvic transaminase, and creatinine were significantly increased after operation compared with before operation (P < 0.05), but there was no significant difference between the two groups (P > 0.05), suggesting that the method of implanting sustained-release fluorouracil for modified radical mastectomy was safe, and it might become an effective way to local chemotherapy for breast cancer postoperatively.