CAJ | 학술논문

目的探讨胃窦癌术中区域动脉灌注化疗的作用.方法本组32例胃窦癌患者术中经胃网膜右动脉灌注5-氟尿嘧啶(5-Fu,1000 mg/m2),用高效液相色谱法测定注药后2、5、10、20、30、60 min门静脉血、周围静脉血、腹腔渗液及切除癌组织中5-Fu的浓度.结果于注药后2 min门静脉血及腹腔渗液即出现峰浓度,分别为(48.8±6.8)μg/ml及(75.3±30.7)μg/ml,于注药后30 min门静脉血的浓度为(19.2±2.0)μg/ml,于注药后60 min腹腔渗液的浓度为(17.3±7.4) μg/ml,均超过有效抑癌浓度(15 μg/ml)；于注药后5 min周围静脉血出现峰浓度,为(5.4±2.0) μg/ml,此后逐渐降低；手术切下的癌组织的药物浓度为(80.5±20.1)Lg/ml.结论胃窦癌术中区域动脉灌注化疗可以在短时间内使门静脉血及腹腔渗液达到较高的药物浓度且持续时间长,术后切下的癌组织药物浓度远较周围血为高,有利于预防术中癌细胞的扩散及术后癌复发.
목적 탐토위두암술중구역동맥관주화료적작용.방법 본조32례위두암환자술중경위망막우동맥관주5-불뇨밀정(5-Fu,1000 mg/m2),용고효액상색보법측정주약후2、5、10、20、30、60 min문정맥혈、주위정맥혈、복강삼액급절제암조직중5-Fu적농도.결과 우주약후2 min문정맥혈급복강삼액즉출현봉농도,분별위(48.8±6.8)μg/ml급(75.3±30.7)μg/ml,우주약후30 min문정맥혈적농도위(19.2±2.0)μg/ml,우주약후60 min복강삼액적농도위(17.3±7.4) μg/ml,균초과유효억암농도(15 μg/ml)；우주약후5 min주위정맥혈출현봉농도,위(5.4±2.0) μg/ml,차후축점강저；수술절하적암조직적약물농도위(80.5±20.1)Lg/ml.결론 위두암술중구역동맥관주화료가이재단시간내사문정맥혈급복강삼액체도교고적약물농도차지속시간장,술후절하적암조직약물농도원교주위혈위고,유리우예방술중암세포적확산급술후암복발.
Objective To measure 5Fu concentration after intraoperative regional arterial perfusion chemotherapy in gastric antrum cancer patients.Method In this study,32 gastric antrum cancer patients intraoperatively received through right gastroepiploic artery intraarterial perfusion of 5-Fu (1000 mg/m2),and drug conentrations were measured in portal venous blood,peripheral venous blood,peritoneal fluid and in removed cancer tissues 2,5,10,20,30,60 minutes after infusion started by high performance liquid chromatography method.Result 5-Fu in portal vein blood and peritoneal fluid reached peak concentration after 2 minutes at (48.8 ±6.8) μg1/ml and (75.3 ±30.7) μg/ml,respectively.The drug concentration in portal venous blood was (19.2 ± 2.0) μg/ml at 30 minutes and that in peritoneal fluid was (17.3 ±7.4) μg/ml at 60 minutes,both were higher than that of the effective experimental tumor suppressing concentration (15 μg/ml).Peripheral venous blood concentration reached peak concentration of (5.4 ± 2.0) μg/ml at 5 minute.The drug concentration in removed cancer tissues was (80.5 ± 20.1) μg,/ml.Conclusions Regional intraarterial perfusion chemotherapeutics in gastric antrum cancer patients during operation immediately makes the concentration of chemotherapy rise in the portal vein blood and peritoneal fluid and in cancer tissues to a much higher level than that in peripheral blood.This helps kill cancer cells that fell out during the surgery.