CAJ | 학술논문

目的：去氧氟尿苷、顺铂联合艾迪注射液腹腔灌注治疗恶性腹水的疗效观察。方法：经 B超定位，采用深静脉导管行腹腔穿刺置管引流。第1d引流1000 mL ，第2d引流2000～3000mL ，第3d引流至腹水不再流出后用温生理盐水2000 mL 腹腔灌注并不断变动体位，30分钟后再引流放出，以减少腹腔粘连。每天予静脉补充白蛋白10～20g ，补液1000～2000mL（视情况而定），注意电解质平衡，输液完毕予速尿20 mg静推。之后将去氧氟尿苷1 g＋顺铂100 mg ＋艾迪注射液100 mL＋ NS2000～3000mL ，腹腔注入（ip），辅以静脉止吐。注药后嘱患者缓慢变换体位，以利药物均匀分布，每周1次，一般2、3次观察疗效。结果：CR10例，PR14例，NR4例，总有效率85．7％，毒性反应较轻，主要为恶心、呕吐，予对症处理缓解，不影响治疗。骨髓抑制率低，均为Ⅰ°，肝肾功损害轻，未发现心电图改变者及色素沉着。结论：该法有效率高，毒副反应小，治疗方便安全，不仅改善症状，提高了生活质量，作为姑息治疗手段，值得临床推广．
목적：거양불뇨감、순박연합애적주사액복강관주치료악성복수적료효관찰。방법：경 B초정위，채용심정맥도관행복강천자치관인류。제1d인류1000 mL ，제2d인류2000～3000mL ，제3d인류지복수불재류출후용온생리염수2000 mL 복강관주병불단변동체위，30분종후재인류방출，이감소복강점련。매천여정맥보충백단백10～20g ，보액1000～2000mL（시정황이정），주의전해질평형，수액완필여속뇨20 mg정추。지후장거양불뇨감1 g＋순박100 mg ＋애적주사액100 mL＋ NS2000～3000mL ，복강주입（ip），보이정맥지토。주약후촉환자완만변환체위，이리약물균균분포，매주1차，일반2、3차관찰료효。결과：CR10례，PR14례，NR4례，총유효솔85．7％，독성반응교경，주요위악심、구토，여대증처리완해，불영향치료。골수억제솔저，균위Ⅰ°，간신공손해경，미발현심전도개변자급색소침착。결론：해법유효솔고，독부반응소，치료방편안전，불부개선증상，제고료생활질량，작위고식치료수단，치득림상추엄．
Objective :Doxifluridine ,cisplatin ,Aidi intraperitoneal injection efficacy of treatment of malignant ascites .M ethods :B -posi-tion ,deep-vein catheter drainage of abdominal puncture .Day 1 draining 1000 mL ,the first two days drainage 2000 ~ 3000mL ,the first 3 days after the drainage to the ascites is no longer out of abdominal cavity with warm saline 2000 mL infusion and the changing position ,30 mi-nutes before draining release in order to reduce intra -abdominal adhesions .I added a daily intravenous albumin 10 ~ 20g ,rehydration 1000~ 2000mL (as the case may be) ,pay attention to electrolyte balance ,I finished infusion 20 mg bolus of furosemide .Will be followed by Doxifluridine 1 g + cisplatin 100 mg + Aidi injection 100 mL + NS2000 ~ 3000mL ,intraperitoneal injection (ip) ,supplemented by intrave-nous antiemetic .After injection Zhu Huanzhe slowly changing position in order to facilitate uniform distribution of drugs a week ,a second , generally observe the effect of 2 ,3 times .Results :CR 10 cases ,PR 14 cases ,NR 4 cases ,the total effective rate was 85 .7% ,mild toxicity , mainly nausea ,vomiting ,symptomatic treatment to alleviate does not affect the treatment .The low rate of bone marrow suppression ,both Ⅰdegree of light damage to liver and kidney function ,ECG changes were not found ,and pigmentation .Conclusion :This method has high effi-ciency and toxicity is small ,convenient and safe treatment ,not only to improve symptoms ,improve the quality of life ,as a palliative treatment , worthy to be popularized .