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目的 减少中晚期消化系统恶性肿瘤术后腹腔内复发和肝转移率。方法 术后将患者随机分成腹腔化疗组 (观察组 )和静脉化疗组 (对照组 ) ,观察组 5 2例 ,将丝裂霉素 (mitomycinC ,MMC) 6～ 10mg/m2 和 5氟脲嘧啶 (5 flourouracil,5 Fu) 1～ 1 5g/m2 加入按 2 0ml/kg的生理盐水 (normalsaline,NS)中 ,经左右下腹穿刺置管灌注腹腔。对照组 5 3例 ,用MMC 4～ 6mg/m2 +NS 2 0～ 30ml静脉注射及 5 Fu 0 75～ 1g/m2 + 5 %葡萄糖注射液 (glucosesolution ,GS) 5 0 0ml静脉点滴治疗。结果 观察组与对照组相比 ,术后腹腔内复发例数 2 /11,χ2 =6 92 ,P <0 0 1,肝转移例数 0 /7,χ2 =7 36 ,P <0 0 1,近期死亡人数 0 /12 ,χ2 =13 2 9,P <0 0 0 5 ,恶心呕吐反应例数 14/5 3 ,χ2 =6 0 70 ,P <0 0 0 5 ,口腔炎例数0 /7,χ2 =7 36 ,P <0 0 1,肝肾功能损害例数 0 /13 ,χ2 =14 5 6 ,P <0 0 0 5 ,3年以上无瘤存活例数分别为18例及 8例 ,χ2 =5 37,P <0 0 5。结论 对该类患者术后采用MMC + 5 Fu腹腔化疗在减少腹腔内复发和肝转移方面 ,近期疗效优于静脉化疗 ,且毒副作用小于静脉化疗
Objective To reduce postoperative intra-abdominal recurrence and liver metastases of advanced digestive system malignant tumors. Methods The patients were randomly divided into intraperitoneal chemotherapy group (observation group) and intravenous chemotherapy group (control group) after operation. The patients in observation group were treated with mitomycin C (MMC) 6 ~ 10mg / m2 and 5-fluorouracil 5 flourouracil, 5 Fu) 1 ~ 15g / m2 added 20ml / kg of normal saline (NS), peritoneal perfusion through the right and left abdominal puncture. The control group, 53 cases, with MMC 4 ~ 6mg / m2 + NS 2 0 ~ 30ml intravenous injection and 5 Fu 0 75 ~ 1g / m2 + 5% glucose injection (glucosesolution, GS) 500ml intravenous drip treatment. Results The number of intraperitoneal recurrence in observation group was 2/11, χ2 = 6 92, P 0 01, the number of hepatic metastasis 0/7, χ2 = 7 36, P 0 01, The number of recent deaths was 0/12, χ2 = 13 2 9, P <0 0 05, the number of nausea and vomiting reactions was 14/5 3, χ2 = 60 70, P 0 05, and the number of stomatitis was 0/7 , χ2 = 7 36, P 0 01, the number of hepatic and renal dysfunction cases 0/13, χ2 = 14 5 6, P 0 055, the number of tumor-free survival over 3 years were 18 cases and 8 cases , χ2 = 5 37, P <0 0 5. Conclusion In this kind of patients, MMC + 5 Fu intraperitoneal chemotherapy is better than intravenous chemotherapy in reducing intraperitoneal recurrence and liver metastasis, and the side effects are less than that of intravenous chemotherapy