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目的腹腔热灌注化疗(intraperitoneal hyperthermic perfusion chemotherapy,IHPC)已成为继手术、传统化疗和放疗等后一种有效的肿瘤治疗方法,本研究探讨IHPC对患者肾功能的影响,为患者治疗过程中肾功能的变化提供参考依据。方法 2012-04-01-2013-04-01威海市立医院胃肠外科收治结肠癌患者113例,按照治疗方式分成2组,A组58例,均完成手术后给予常规术后恢复治疗;B组55例,除给予常规术后恢复治疗外,于术后6h内完成IHPC,治疗条件:43℃,60min,300~500 mL/min,灌注生理盐水3 500~4 500 mL,灌注顺铂60 mg、5-氟尿嘧啶(5-fluorouracil,5-FU)1g。监测患者术后24、72h以及1周的肾功能及24h尿量变化。结果 B组术后24h尿量为(1 162±93)mL,较A组的(1 536±78)mL明显减少,差异有统计学意义,t=23.21,P<0.001;术后72h(t=1.49,P=0.138)及1周(t=0.90,P=0.372)差异无统计学意义。B组术后24h的尿素氮(blood urea nitrogen,BUN)为(7.8±3.2)mmol/L,与A组的(6.4±1.6)mmol/L相比差异有统计学意义,t=2.96,P<0.05;术后72h(t=1.51,P=0.135)及1周(t=0.52,P=0.606)差异无统计学意义。B组术后24h的肌酐(serum creatinine,SCr)为(108±7.2)μmol/L,较A组的(92±5.4)μmol/L明显升高,差异有统计学意义,t=13.41,P<0.001;术后72h(t=1.53,P=0.129)及1周(t=0.87,P=0.386)差异无统计学意义。结论腹腔热灌注化疗早期可影响患者肾功能,但经过不予处理或对症治疗后可恢复,是一种安全的结肠癌辅助治疗方法。
Objective Intraperitoneal hyperthermic perfusion chemotherapy (IHPC) has become an effective method of oncology after surgery, traditional chemotherapy and radiotherapy. This study investigated the effect of IHPC on renal function in patients with renal function The change provides the reference basis. Methods A total of 113 patients with colon cancer were enrolled in the Department of Gastrointestinal Surgery, Weihai Municipal Hospital. The patients were divided into two groups according to the mode of treatment. Group A (58 cases) received conventional postoperative recovery treatment after operation. Group B In 55 cases, IHPC was completed within 6 hours after operation. The treatment conditions were as follows: 43 ℃, 60 min, 300 ~ 500 mL / min, perfusion of normal saline 3 500-4 500 mL, perfusion of cisplatin 60 mg , 5-fluorouracil (5-FU) 1g. The changes of renal function and 24h urine volume were monitored at 24, 72h and 1 week after operation. Results The urine output of group B after operation was (162 ± 93) mL, significantly lower than that of group A (536 ± 78) mL, the difference was statistically significant, t = 23.21, = 1.49, P = 0.138) and 1 week (t = 0.90, P = 0.372), no significant difference. Blood urea nitrogen (BUN) at 24 hours after operation in group B was (7.8 ± 3.2) mmol / L, which was significantly lower than that in group A (6.4 ± 1.6) mmol / L, t = 2.96 <0.05; there was no significant difference at 72h after operation (t = 1.51, P = 0.135) and 1 week (t = 0.52, P = 0.606). Serum creatinine (SCr) at 24h in group B was (108 ± 7.2) μmol / L, which was significantly higher than that in group A (92 ± 5.4) μmol / L, the difference was statistically significant, t = 13.41, P <0.001; there was no significant difference at 72h after operation (t = 1.53, P = 0.129) and 1 week (t = 0.87, P = 0.386). Conclusion Intraperitoneal hyperthermic perfusion chemotherapy can affect renal function in patients with early renal failure, but it can be recovered after treatment or symptomatic treatment. It is a safe adjuvant treatment of colon cancer.