老年结肠癌术中术后腹腔内温热灌注化疗的临床研究

目的探讨老年结肠癌根治术中及术后腹腔内温热灌注化疗的临床疗效及对肝功与血液系统的影响。方法将术中、术后腹腔内温热灌注化疗的68例老年结肠癌患者（治疗组）与未行腹腔内温热灌注化疗的81例患者（对照组）的腹腔游离癌细胞（ICC）检出率、肝功能、血细胞分析及预后等进行比较。结果治疗组与对照组的游离癌细胞检出率分别是3.1%及12.8%（P〈0.05）;术后肝功能、血液细胞分析两组差异无显著性（P〉0.05）;治疗组术后1、2、3年内生存率分别为98.0%、86.0%和68.8%,对照则为96.0%、62.1%和48.6%,两组第2、3年生存率相比差异有显著性（P〈0.05）。结论术中及术后腹腔内温热灌注化疗在老年结肠癌患者中可以应用,其方法简便,效果确切,可明显杀灭腹腔游离癌细胞,降低复发率,提高生存率。

Intraoperative and postoperative intraperitoneal thermic chemotherapy for colorectal cancer in the elderly

Objective To investigate the clinical effect and value of intraoperative and postoperative intraperitoneal thermic chemotherapy in advanced colorectal cancer in elderly patients.Methods In this series,68 patients received intraoperatitve and postoperative intraperitoneal thermic chemotherapy(treatment group) and other 81 received only saline water lavage after radical resection(control group).Isolated cancer cells(ICC)in the peritoneal fluid,hepatic function,blood cell analysis and prognosis were compared between the two groups.Results The positive rate of ICC was 3.1% in treatment group and 12.8% in control group(P<0.05).Hepatic function and blood cell analysis did not show significant difference between the two groups.The 1,2,3-year survival rates were 98%,86%,68.8% and 96%,62.6%,48.1%,respectively in treatment and control groups.There were significant differences in the 2,3-year survival rates between the two groups(P<0.05).Conclusion Intraoperative and postoperative intraperitoneal thermic chemotherapy is safe and effective.It can kill isolated intraperitoneal cancer cells,reduce peritoneal recurrence after radical resection,and improve the prognosis in elderly patients with colorectal cancer.