CAJ | 학술논문

目的：了解顺铂等铂类药物应用于胃肠道肿瘤腹腔热灌注后短期肾毒性的发生情况。方法：从我科消化道肿瘤数据库中选择2012年1月至2013年7月期间行持续腹腔热灌注治疗的患者作为研究对象，根据治疗过程灌注液是否使用铂类药物分为观察组(铂类组)与对照组(无铂类组)，观察两组患者治疗结束前后肾功能变化、疼痛评分、血清白蛋白水平及住院日。结果：99例患者纳入分析，47例接受铂类腹腔灌注治疗。铂类治疗组灌注后血尿素氮、肌酐水平明显升高，且显著高于对照组(P<0.05)。4例患者出现急性肾损害，6例出现轻微肾功能不全，肾毒性发生率为21.3%。两组患者术后疼痛评分、白蛋白水平及住院日无显著性差异。结论：腹腔持续热灌注联合铂类治疗可能增加急性肾损害风险。
목적：료해순박등박류약물응용우위장도종류복강열관주후단기신독성적발생정황。방법：종아과소화도종류수거고중선택2012년1월지2013년7월기간행지속복강열관주치료적환자작위연구대상，근거치료과정관주액시부사용박류약물분위관찰조(박류조)여대조조(무박류조)，관찰량조환자치료결속전후신공능변화、동통평분、혈청백단백수평급주원일。결과：99례환자납입분석，47례접수박류복강관주치료。박류치료조관주후혈뇨소담、기항수평명현승고，차현저고우대조조(P<0.05)。4례환자출현급성신손해，6례출현경미신공능불전，신독성발생솔위21.3%。량조환자술후동통평분、백단백수평급주원일무현저성차이。결론：복강지속열관주연합박류치료가능증가급성신손해풍험。
Objective: To investigate the incidence of cisplatin-induced nephrotoxicity through hyperthermic intraperitoneal chemotherapy (HIPEC) for gastrointestinal tumors.Methods: From January 2012 to July 2013, a consecutive series of 99 patients undergoing HIPEC were retrospectively reviewed. hTe patients were divided into cisplatin group and non-cisplatin group, and received HIPEC combined with cisplatin or not. Renal function parameters, nutritional status and immune function were compared between the two groups.Results: Based on the RIFLE classiifcation, four patients developed acute kidney injury and six slight renal insuffciency in the cisplatin group, and no patients had renal failure. The incidence of cisplatin-induced nephrotoxicity was 21.3%. The BUN and creatinine levels signiifcantly increased atfer perfusion therapy in the cisplatin group, were signiifcantly higher than those in the non-cisplatin group. However, there were no signiifcant differences in postoperative pain scaled with VAS score, albumin level and hospital stay between the two groups.Conclusion: Cisplatin-based HIPEC could increase the risk of postoperative nephrotoxicity. Renal function should be strictly monitored during cisplatin-based chemotherapy.