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目的观察术中、术后辅用铜绿甲单胞杆菌(pseudomonas aeruginosa,PA)注射液的低渗温热灌注化疗对III期胃癌的治疗效果。方法选择接受规范的D2/D3根治术的III期胃癌68例,按随机、对照的原则分为术中/术后辅用PA注射液的低渗温热灌注化疗组34例(治疗组)和术中/术后未辅用PA注射液的低渗温热灌注化疗组34例(对照组),了解治疗后的并发症、腹膜种植转移和生存情况。结果两组间粘连性肠梗阻、肝肾功能损伤、腹腔感染和胃肠道副反应的对比差异无统计学意义(P>0.05)。治疗组骨髓抑制明显降低,两组对比差异有统计学意义(P<0.05)。治疗组1年、2年、3年的腹膜种植转移发生率分别为5.88%、14.71%、20.59%,对照组11.76%、26.47%、44.12%,3年对比差异有统计学意义(P<0.05)。生存率的对比差异无统计学意义(P>0.05)。结论 III期胃癌患者术中、术后辅用PA注射液的腹腔低渗温热灌注化疗,可进一步降低腹膜种植转移的发生。
Objective To observe the effect of intraoperative and postoperative infusion of hypocaloric hyperthermic perfusion chemotherapy with pseudomonas aeruginosa injection on stage III gastric cancer. Methods A total of 68 patients with stage III gastric cancer undergoing D2 / D3 radical resection were enrolled in this study. According to the randomized and controlled principle, 34 patients (treatment group) and Intraoperative / postoperative non-adjuvant PA infusion hypotonic warm perfusion chemotherapy group of 34 patients (control group) to understand the postoperative complications, peritoneal implantation and metastasis and survival. Results There was no significant difference in adhesive intestinal obstruction, hepatic and renal dysfunction, abdominal infection and gastrointestinal side effects between the two groups (P> 0.05). The bone marrow suppression of the treatment group was significantly lower, the difference between the two groups was statistically significant (P <0.05). The incidences of peritoneal implantation in the treatment group were 5.88%, 14.71% and 20.59% at 1 year, 2 years and 3 years respectively, and those in the control group were 11.76%, 26.47% and 44.12% ). There was no significant difference in survival rate (P> 0.05). Conclusions Intraperitoneal hyperthermic perfusion chemotherapy with PA injection intraoperatively and postoperatively can further reduce the incidence of peritoneal metastasis in patients with stage III gastric cancer.