雷替曲塞术中腹腔灌注化疗对结直肠癌的安全性和近期疗效研究

胡军 段浩清 罗俊峰

【摘要】 目的：探讨雷替曲塞对结直肠癌术中腹腔灌注化疗的安全性和近期疗效。方法：回顾性分析本院2015年1月-2017年6月收治的结直肠癌患者60例的临床资料。根据治疗方法不同分为观察组（根治性切除手术+腹腔灌注化疗）和对照组（根治性切除手术+腹腔灌注生理盐水），各30例。比較两组患者术后一般情况、并发症、术后肛门排气时间、住院时间及近期疗效（1年复发转移率），比较两组手术前后白细胞计数、血小板计数、谷丙转氨酶（ALT）、肌酐（Cr）。结果：两组患者均未发生死亡、切口感染、吻合口瘘、腹腔出血等情况（P>0.05），且两组患者术后发热、呕吐、腹痛发生率比较差异均无统计学意义（P>0.05）；两组患者术后肛门排气时间、住院时间比较，差异均无统计学意义（P>0.05），观察组术后1年复发转移率为6.7%，低于对照组的26.7%，比较差异有统计学意义（P<0.05）；手术前后，两组患者白细胞计数、血小板、ALT、Cr比较，差异均无统计学意义（P>0.05）。结论：对经过选择的病例，结直肠癌术中雷替曲塞腹腔灌注化疗，安全可靠，可以降低术后1年复发转移率。

【关键词】 术中腹腔灌注化疗； 结直肠癌； 雷替曲塞

【Abstract】 Objective：To evaluate the safety and short-term efficacy of intraoperative peritoneal perfusion chemotherapy with Raltitrexed in patients with colorectal cancer.Method：The clinical data of 60 patients with colorectal cancer admitted to our hospital from January 2015 to June 2017 were retrospectively analyzed.According to the different treatment methods，they were divided into observation group （radical resection+intraperitoneal chemotherapy） and control group （radical resection+intraperitoneal infusion of normal saline），30 cases in each group.The general conditions，complications，postoperative anal exhaust time，hospitalization time and short-term efficacy（1 year recurrence and metastasis rate） between two groups were compared，the white blood cell count，platelet count，alanine aminotransferase（ALT） and creatinine（Cr） before and after operation between two groups were compared.Result：There was no death，incision infection，anastomotic leakage or abdominal bleeding in two groups（P>0.05），and the incidence of postoperative fever，vomiting and abdominal pain in two groups were compared，the differences were not statistically significant（P>0.05）.The postoperative anal exhaust time and hospitalization time in two groups were compared，the differences were not statistically significant（P>0.05）.The 1 year recurrence and metastasis rate was 6.7% in observation group，which was lower than 26.7% in control group（P<0.05）.Before and after operation，white blood cell count，platelet count，ALT and Cr between two groups were compared，the differences were not statistically significant（P>0.05）.Conclusion：For selected cases，intraoperative peritoneal perfusion chemotherapy with Raltitrexed in patients with colorectal cancer is safe and reliable，and can reduce the recurrence and metastasis rate after 1 year.

【Key words】 Intraoperative peritoneal perfusion chemotherapy； Colorectal cancer； Raltitrexed

First-authors address：Yichun Peoples Hospital，Yichun 336000，China

doi：10.3969/j.issn.1674-4985.2018.31.005

结直肠癌在我国是常见的消化系统肿瘤，目前手术切除仍然是主要治疗手段，然而，大部分患者确诊时已为进展期，术后复发率较高[1]。有学者通过研究发现，术中腹腔灌注化疗可以消除亚临床微小病灶，是防止局部复发的重要方法之一[2]。笔者所在医院科室从2015年起将雷替曲塞用于进展期结直肠癌术中腹腔灌注化疗，取得了较好的效果，现报道如下。

1 资料与方法

1.1 一般资料 回顾性分析本院2015年1月-2017年6月收治的结直肠癌患者60例的临床资料。纳入标……