CAJ | 학술논문

目的：探讨围术期腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy，HIPEC）治疗胃肠癌的安全性及临床初步疗效。方法：回顾性分析2012年5月至2013年10月我院收治的围术期进行 HIPEC的60例进展期胃癌、结直肠癌患者的临床资料，观察患者切口愈合、并发症、KPS 评分、血清 CEA 等指标。结果：患者 HIPEC 过程生命体征稳定；无出现围术期死亡、肠梗阻、胃肠穿孔、腹腔内出血等严重并发症；28例行胃-肠或肠-肠吻合者，无吻合口瘘； HIPEC 后，患者血钾、血钠、血清白蛋白下降，KPS 评分增加，CEA下降（P ＜0．01），差异均有显著统计学意义；29例癌性腹水患者20例腹水完全缓解、8例部分缓解，1例稳定，有效率为96．5％。结论：围术期 HIPEC 治疗胃肠癌安全可行，能显著改善患者生活质量，控制恶性腹水近期疗效确切，且不增加围术期的并发症。
목적：탐토위술기복강열관주화료（hyperthermic intraperitoneal chemotherapy，HIPEC）치료위장암적안전성급림상초보료효。방법：회고성분석2012년5월지2013년10월아원수치적위술기진행 HIPEC적60례진전기위암、결직장암환자적림상자료，관찰환자절구유합、병발증、KPS 평분、혈청 CEA 등지표。결과：환자 HIPEC 과정생명체정은정；무출현위술기사망、장경조、위장천공、복강내출혈등엄중병발증；28례행위-장혹장-장문합자，무문합구루； HIPEC 후，환자혈갑、혈납、혈청백단백하강，KPS 평분증가，CEA하강（P ＜0．01），차이균유현저통계학의의；29례암성복수환자20례복수완전완해、8례부분완해，1례은정，유효솔위96．5％。결론：위술기 HIPEC 치료위장암안전가행，능현저개선환자생활질량，공제악성복수근기료효학절，차불증가위술기적병발증。
Objective To observe the preliminary effect and safety of perioperative hyperthermic intraperitonral chemotherapy to treat gastrointestinal cancer. Methods The clinical data of 60 patients with progressed gastric or colorectal carcinoma who underwent perioperatively HIPEC in our hospital from May, 2012 to October, 2013 were retrospectively analyzed. The incision healing, complications, KPS scores and serum CEA levels were observed. Results The vital signs of all patients were normal during HIPEC. There was no perioperative death. No patients underwent serious complications like diffuse peritonitis, intestinal obstruction, gastrointestinal perforation or intraperitoneal bleeding. There was no anastomotic leakage in 28 patients who underwent Stomach-jejunum anastomosis or intestinal anastomosis. After HIPEC, the life quality was improved;increase in KPS score and reduction in serum CEA levels were noted in all patients (P < 0.01). Of 29 patients with malignant ascites, 20 cases achieved complete mitigation and 8 cases achieved partial mitigation, 1 case was in stable condition, thus yielding effective rate of 96.5%. Conclusions It is safe and feasible for HIPEC to treat gastrointestinal cancer. HIPEC can improve the patients’ life qualities, without theincrease in perioperative complications. The short-term effect of HIPEC is confirmed in alleviating ascites.