盆腔淋巴结清扫术后应用腹腔热灌注化学治疗效果
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摘要
目的分析盆腔淋巴结清扫术后应用腹腔热灌注化学治疗(HIPEC)效果。方法选取2017年12月-2018年12月于本院行腹腔镜下盆腔淋巴结清扫术的早期妇科恶性肿瘤患者146例,由数字随机表法分组,研究组73例进行腹腔热灌注化学治疗,对照组73例不进行腹腔热灌注化学治疗,回顾分析研究组患者腹腔灌洗液细胞学检查结果,对比两组患者不良反应发生率、并发症发生率。结果研究组患者经腹腔灌洗液细胞学检查显示:核异质细胞退变坏死有20例,检查结果正常有53例,研究组患者术后并发症发生率明显低于对照组(P <0.05),两组不良反应发生率比较差异无统计学意义(P> 0.05)。结论盆腔淋巴结清扫术后应用腹腔热灌注化学治疗(HIPEC)效果较显著,可及时预防患者腹腔种植移植,对患者预后康复具有积极促进作用。
Objective To analyze the effect of hyperthermic intraperitoneal perfusion chemotherapy(HIPEC) after pelvic lymph node dissection.Methods 146 patients with early gynecological malignant tumors who underwent laparoscopic pelvic lymphadenectomy in our hospital from December 2017 to December 2018 were selected. They were divided into two groups by digital random table method. 73 patients in the study group were given hyperthermic intraperitoneal chemotherapy, while 73 patients in the control group did not receive hyperthermic intraperitoneal chemotherapy. The results of cytological examination of peritoneal lavage fluid in the two groups were retrospectively analyzed and compared.The incidence of adverse reactions and complications were compared.Results Cytological examination of peritoneal lavage fluid in the study group showed that there were 20 cases of degenerative necrosis of nuclear heterogeneous cells and 53 cases of normal results. The incidence of complications in the study group was significantly lower than that in the control group(P < 0.05), and the incidence of adverse reactions in the two groups was similar(P > 0.05). Conclusion The effect of intraperitoneal hyperthermic perfusion chemotherapy(HIPEC) after pelvic lymph node dissection is remarkable. It can prevent peritoneal implantation and transplantation in time, and play an active role in promoting the prognosis and rehabilitation of patients.
Objective To analyze the effect of hyperthermic intraperitoneal perfusion chemotherapy(HIPEC) after pelvic lymph node dissection.Methods 146 patients with early gynecological malignant tumors who underwent laparoscopic pelvic lymphadenectomy in our hospital from December 2017 to December 2018 were selected. They were divided into two groups by digital random table method. 73 patients in the study group were given hyperthermic intraperitoneal chemotherapy, while 73 patients in the control group did not receive hyperthermic intraperitoneal chemotherapy. The results of cytological examination of peritoneal lavage fluid in the two groups were retrospectively analyzed and compared.The incidence of adverse reactions and complications were compared.Results Cytological examination of peritoneal lavage fluid in the study group showed that there were 20 cases of degenerative necrosis of nuclear heterogeneous cells and 53 cases of normal results. The incidence of complications in the study group was significantly lower than that in the control group(P < 0.05), and the incidence of adverse reactions in the two groups was similar(P > 0.05). Conclusion The effect of intraperitoneal hyperthermic perfusion chemotherapy(HIPEC) after pelvic lymph node dissection is remarkable. It can prevent peritoneal implantation and transplantation in time, and play an active role in promoting the prognosis and rehabilitation of patients.
引文
[1]张伶俐,黄群,王南苏.超声刀在腹腔镜下妇科恶性肿瘤盆腔淋巴结清扫术中的应用[J].现代肿瘤医学,2016,24(7):1114-1116.
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[9]张林风,孙文妹,李文娟.先期化疗联合肿瘤细胞减灭术后腹腔热灌注化疗治疗晚期卵巢癌的临床疗效分析[J].实用癌症杂志,2016,31(9):1495-1497.
[10]刘渤娜,尤振宇,刘学飞.腹腔热灌注联合静脉化疗治疗进展期胃肠道恶性肿瘤并腹水临床研究[J].现代仪器与医疗,2015,21(3):35-38.
[11]李雁,周云峰,梁寒,等.细胞减灭术加腹腔热灌注化疗治疗腹膜表面肿瘤的专家共识[J].中国肿瘤临床,2015,42(4):198-206.
[12]帖晓静,徐志巧,徐月,等.重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液疗效观察[J].中华实用诊断与治疗杂志,2016,30(4):412-414.
[13]陈雍,王根和,张徽声,等.腹盆腔恶性肿瘤热灌注化疗与单纯灌注化疗联合高频热疗的临床疗效对比分析[J].临床药物治疗杂志,2017,15(3):40-45.
[2]康山.腹腔镜妇科恶性肿瘤淋巴结清扫术中并发症及处理[J].中国实用妇科与产科杂志,2015,31(5):395-398.
[3]钟育波,邱磊,谢沛标,等.腹腔镜下结直肠癌根治术中联合腹腔热灌注化疗的临床研究[J].中国普通外科杂志,2015,24(4):467-472.
[4]叶国.腹腔镜盆腹腔淋巴结清扫术后淋巴囊肿的诊治进展[J].中国微创外科杂志,2017,17(4):364-367.
[5]任红娟,李鹏.肿瘤细胞减灭术联合腹腔热灌注化疗术治疗晚期妇科恶性肿瘤来源腹膜癌患者的效果及安全性[J].广东医学,2016,37(22):3440-3444.
[6]郝希山.细胞减灭术加腹腔热灌注化疗治疗腹膜表面肿瘤的专家共识导读[J].中国肿瘤临床,2015,42(4):197.
[7]陈雨柔,张蔚.妇科恶性肿瘤腹腔镜下腹膜外腹主动脉旁淋巴结切除术的意义探讨[J].现代妇产科进展,2017,26(8):624-626.
[8]李晶,林仲秋.妇科恶性肿瘤腹腔热灌注化疗临床应用专家共识[J].中国实用妇科与产科杂志,2017,33(9):926-932.
[9]张林风,孙文妹,李文娟.先期化疗联合肿瘤细胞减灭术后腹腔热灌注化疗治疗晚期卵巢癌的临床疗效分析[J].实用癌症杂志,2016,31(9):1495-1497.
[10]刘渤娜,尤振宇,刘学飞.腹腔热灌注联合静脉化疗治疗进展期胃肠道恶性肿瘤并腹水临床研究[J].现代仪器与医疗,2015,21(3):35-38.
[11]李雁,周云峰,梁寒,等.细胞减灭术加腹腔热灌注化疗治疗腹膜表面肿瘤的专家共识[J].中国肿瘤临床,2015,42(4):198-206.
[12]帖晓静,徐志巧,徐月,等.重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液疗效观察[J].中华实用诊断与治疗杂志,2016,30(4):412-414.
[13]陈雍,王根和,张徽声,等.腹盆腔恶性肿瘤热灌注化疗与单纯灌注化疗联合高频热疗的临床疗效对比分析[J].临床药物治疗杂志,2017,15(3):40-45.