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目的探讨肝癌切除术中植入5-氟尿嘧啶(5-Fu)缓释剂进行区域性化疗的安全性及临床疗效。方法选择2011-2012年于新疆医科大学第一附属医院腔镜肝移植外科就诊的可经手术探查并能完整切除的肝癌患者54例,随机分为5-Fu缓释剂残肝断面植入组(植入组,26例)及对照组(28例)。所有患者分别于入院第1天和术后第14天采血,术后2w观察并记录两组患者的不良反应、血常规、肝肾功能及肿瘤标记物水平,并对其观察结果进行统计学分析。结果 (1)术后2w植入组与对照组患者白细胞计数及肾功能分级比较差异无统计学意义(P>0.05);(2)术后2w植入组与对照组患者不良反应(恶心呕吐、发热分度、脱发分度)比较差异无统计学意义(P>0.05);(3)植入组与对照组患者术后切口愈合等级比较差异无统计学意义(P>0.05);(4)术后2w植入组与对照组患者ALT、AST、TBL及PT比较差异无统计学意义(P>0.05),AFP比较差异具有统计学意义(P<0.05)。结论肝癌切除术中植入5-Fu缓释剂短期内无明显药物毒副作用,对血常规及肝肾功能无显著影响,能显著降低AFP水平,是一种安全可靠有效的局部的化疗药物。
Objective To investigate the safety and clinical efficacy of 5-fluorouracil (5-Fu) sustained-release agent for regional chemotherapy in hepatocellular carcinoma resection. Methods From 2011 to 2012, 54 patients with hepatocellular carcinoma who underwent endoscopic surgical resection and complete resection in the First Affiliated Hospital of Xinjiang Medical University were randomly divided into 5-Fu sustained-release residual liver transection group (Implantation group, 26 cases) and control group (28 cases). All patients were collected on the first day of admission and 14 days after the operation. The adverse reaction, blood routine, liver and kidney function and tumor marker levels were observed and recorded in 2 weeks after operation. Statistical analysis was made on the observation results . Results (1) There were no significant differences in the white blood cell count and renal function grading between the 2-day postoperative 2w implantation group and the control group (P> 0.05). (2) The incidence of nausea and vomiting (P> 0.05). (3) There was no significant difference in the degree of incision healing between the implanted group and the control group (P> 0.05); (4) There was no significant difference between the two groups There were no significant differences in ALT, AST, TBL and PT between the 2-day implantation group and the control group (P> 0.05). The difference of AFP was statistically significant (P <0.05). Conclusions The 5-Fu sustained-release agent implanted in liver cancer resection has no obvious side effects in short term, no significant effect on blood routine and liver and kidney function, can significantly reduce AFP level, and is a safe, reliable and effective local chemotherapeutic drug.