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目的:观察腹腔留置中心静脉导管引流腹水并注射化疗药物治疗癌性腹水的疗效和患者耐受情况。方法:常规取腹腔穿刺处置入一次性中心静脉导管。每日定量放腹水,(3~5)天内放尽腹水并用温生理盐水1000mL灌洗腹腔,再根据病人一般状况将顺铂(60~100)mg/m2用生理盐水500mL稀释后沿导管缓慢注入腹腔。每周一次,共注药(2~4)次,观察一周,B超探察无腹水后拔管评价疗效。结果:本组32例患者均完成治疗,CR:10例(31.25%);PR:16例(50%);NC:6例(18.75%)。总有效率CR+PR:26例(81.25%)。32例患者中有7例(21.88%)呕吐,8例(25%)白细胞下降,2例(6.25%)腹痛。全部病人均接受该方法,未见明显肝功、肾功及心脏损害,亦未出现种植转移、肠穿孔、肠梗阻及皮肤、腹腔感染。结论:采用腹腔留置中心静脉导管治疗癌性腹水方便,安全有效,患者易于接受。
OBJECTIVE: To observe the efficacy and patient tolerability of ascites from drainage of central venous catheters in the abdominal cavity and injection of chemotherapy drugs for cancerous ascites. METHODS: Routine puncture was performed into disposable central venous catheters. Quantitative ascites daily, (3~5) days, ascites was drained and the abdominal cavity was lavaged with 1000 mL normal saline. According to the patient’s general condition, cisplatin (60-100) mg/m2 was diluted with 500 mL of normal saline and slowly injected along the catheter. Abdominal cavity. Once a week, a total of 2 to 4 injections were given. During the week of observation, B-scans were performed to evaluate the efficacy of extubation after no ascites. Results: All 32 patients in this group completed the treatment, CR: 10 cases (31.25%); PR: 16 cases (50%); NC: 6 cases (18.75%). Total effective CR+PR: 26 cases (81.25%). Among 32 patients, 7 (21.88%) had vomiting, 8 (25%) had leukopenia, and 2 (6.25%) had abdominal pain. All patients received this method. No obvious hepatic function, renal function, and heart damage were observed. Plant metastasis, intestinal perforation, intestinal obstruction, and skin and abdominal infections did not appear. Conclusion: The use of an indwelling central venous catheter for the treatment of cancerous ascites is convenient, safe and effective, and the patient is easy to accept.