临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
z1期
25-29
,共5页
袁玉杰%宋武%徐建波%陈创奇%韩方海%蔡世荣%何裕隆
袁玉傑%宋武%徐建波%陳創奇%韓方海%蔡世榮%何裕隆
원옥걸%송무%서건파%진창기%한방해%채세영%하유륭
胃肠肿瘤%腹腔种植转移%持续腹腔热灌注治疗%肠道功能%热稳定
胃腸腫瘤%腹腔種植轉移%持續腹腔熱灌註治療%腸道功能%熱穩定
위장종류%복강충식전이%지속복강열관주치료%장도공능%열은정
gastrointestinal tumor%peritoneal dissemination%HIPEC%bowel function%stable perfusion temperature
目的：消化道恶性肿瘤晚期患者术中探查多见全腹腔种植转移，术中姑息性切除并行术后腹腔热灌注治疗成为该期患者的重要治疗手段。本研究拟观察热灌注治疗过程中灌注温度的稳定性对术后肠功能恢复的影响。方法：回顾性分析2012年1月至2013年7月期间收治我科的晚期肿瘤患者。共计59例行减瘤术并腹腔热灌注治疗的患者符合入选标准。按热灌注温度稳定性将入选患者分为两组，灌注温度稳定在43℃的患者划归观察组，灌注期间温度较大波动的患者进入对照组。比较两组患者热灌注治疗后排气时间、肠内营养起始时间、排便时间、疼痛( VA S评分)等指标的差别。结果：59例晚期消化道肿瘤患者中共有33(55.9%)例患者灌注期间温度稳定。热稳定灌注组患者的平均排气时间较对照组明显提早(2.3±1.2 vs.3.9±2.2 d，P=0.002)，而术后肠内营养起始时间(4.3±1.5 vs.6.7±2.3 d，P<0.001)及排便时间(5.2±2.1 vs.7.1±2.9 d，P=0.004)也均较对照组提前。此外，热稳定灌注治疗组患者术后疼痛较对照组患者显著减轻(4.5±2.3 vs.6.3±1.3，P<0.001)。结论：腹腔热灌注治疗时维持灌注温度的稳定可有效减轻术后疼痛，促进肠道功能恢复，利于术后营养治疗地实施。
目的：消化道噁性腫瘤晚期患者術中探查多見全腹腔種植轉移，術中姑息性切除併行術後腹腔熱灌註治療成為該期患者的重要治療手段。本研究擬觀察熱灌註治療過程中灌註溫度的穩定性對術後腸功能恢複的影響。方法：迴顧性分析2012年1月至2013年7月期間收治我科的晚期腫瘤患者。共計59例行減瘤術併腹腔熱灌註治療的患者符閤入選標準。按熱灌註溫度穩定性將入選患者分為兩組，灌註溫度穩定在43℃的患者劃歸觀察組，灌註期間溫度較大波動的患者進入對照組。比較兩組患者熱灌註治療後排氣時間、腸內營養起始時間、排便時間、疼痛( VA S評分)等指標的差彆。結果：59例晚期消化道腫瘤患者中共有33(55.9%)例患者灌註期間溫度穩定。熱穩定灌註組患者的平均排氣時間較對照組明顯提早(2.3±1.2 vs.3.9±2.2 d，P=0.002)，而術後腸內營養起始時間(4.3±1.5 vs.6.7±2.3 d，P<0.001)及排便時間(5.2±2.1 vs.7.1±2.9 d，P=0.004)也均較對照組提前。此外，熱穩定灌註治療組患者術後疼痛較對照組患者顯著減輕(4.5±2.3 vs.6.3±1.3，P<0.001)。結論：腹腔熱灌註治療時維持灌註溫度的穩定可有效減輕術後疼痛，促進腸道功能恢複，利于術後營養治療地實施。
목적：소화도악성종류만기환자술중탐사다견전복강충식전이，술중고식성절제병행술후복강열관주치료성위해기환자적중요치료수단。본연구의관찰열관주치료과정중관주온도적은정성대술후장공능회복적영향。방법：회고성분석2012년1월지2013년7월기간수치아과적만기종류환자。공계59례행감류술병복강열관주치료적환자부합입선표준。안열관주온도은정성장입선환자분위량조，관주온도은정재43℃적환자화귀관찰조，관주기간온도교대파동적환자진입대조조。비교량조환자열관주치료후배기시간、장내영양기시시간、배편시간、동통( VA S평분)등지표적차별。결과：59례만기소화도종류환자중공유33(55.9%)례환자관주기간온도은정。열은정관주조환자적평균배기시간교대조조명현제조(2.3±1.2 vs.3.9±2.2 d，P=0.002)，이술후장내영양기시시간(4.3±1.5 vs.6.7±2.3 d，P<0.001)급배편시간(5.2±2.1 vs.7.1±2.9 d，P=0.004)야균교대조조제전。차외，열은정관주치료조환자술후동통교대조조환자현저감경(4.5±2.3 vs.6.3±1.3，P<0.001)。결론：복강열관주치료시유지관주온도적은정가유효감경술후동통，촉진장도공능회복，리우술후영양치료지실시。
Objective: The peritoneal carcinomatosis commonly occurs in end stage of various digestive malignances. Combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been widely accepted as effective palliative treatments for patients in end stage malignances. hTis study was designed to investigate whether a stable perfusion temperature could enhance bowel recovery after palliative surgery. Methods: A consecutive series of 59 patients underwent CRS and HIPEC between January 2012 and July 2013 were retrospectively reviewed. All patients were artificially divided into two groups according to the stability of perfusion temperature: study group with stable perfusion temperature and control group with unstable temperature. After three cycles of HIPEC treatments, flatus time, enteral nutrition initiation time, defecation recovery time and postoperative pain (VAS score) were utilized to compare bowel function recovery between the two groups.Results: In all, 33 of 59 (55.9%) patients underwent relatively stable hyperthermic perfusion treatments. Compared with those who had unstable perfusion temperature, the average flatus time (2.3±1.2 vs. 3.9±2.2 days,P=0.002) and time of enteral nutrition initiation (4.3±1.5 vs. 6.7±2.3 days,P<0.001) were significantly decreased in the study group, as well as the defecation recovery time (5.2±2.1 vs. 7.1±2.9 days, P=0.004). Besides, the average VAS score was markedly decreased (4.5±2.3 vs. 6.3±1.3,P<0.001).Conclusion:A stable perfusion temperature during the HIPEC therapy can promote bowel function recovery, reduce postoperative pain, and beneift the initiation of subsequent enteral nutrition therapy.
