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目的 评价术前动脉灌注化疗药物在乳癌治疗中的作用。方法 采用Ｓｅｌｄｉｎｇｅｒ 法经皮股动脉穿刺，将导管置于锁骨下动脉与胸廓内动脉开口交界处的近侧，用充气止血带高于患者收缩压阻断患侧肱动脉血流后，注入化疗药物。根据病人情况３ ～４ 周重复灌注化疗１ 次。化疗方案：吡喃阿霉素（ＴＨＰ） ，或阿霉素（ＡＤＲ） ，或表阿霉素（ ＥＡＤＲ）５０ ～７０ ｍｇ／ｍ２ ，卡铂（ＣＰＢ）３００ ～４００ ｍｇ／ｍ２ ，５氟脲嘧啶（５Ｆｕ）７５０ ～１ ０００ ｍｇ／ｍ２ ，甲酰四氢叶酸钙（ ＣＦ）１００ ～２００ ｍｇ 。结果 本组３２ 例，随访６ 个月～７ 年（ 平均３６ 个月） ，ＣＲ２ 例，ＰＲ２５ 例，ＭＲ５ 例，总缓解率（ＣＲ＋ ＰＲ）８４．４ ％ ；６ 例曾接受全身化疗者ＰＲ５ 例，ＭＲ１ 例；２ 例曾行局部放疗者均为ＰＲ。结论 动脉内灌注化疗药物对提高乳腺癌的生存率有积极意义，且对全身化疗或局部放疗无效者仍有可能通过动脉灌注取得较好效果。
Objective To evaluate the role of preoperative arterial infusion chemotherapy in the treatment of breast cancer. Methods Seldinger method was used for percutaneous femoral artery puncture. The catheter was placed proximal to the junction of the subclavian artery and the internal thoracic artery. The infusion of chemotherapeutic drugs was performed using a pneumatic tourniquet that was higher than the patient’s systolic blood pressure to block the iliac arterial blood flow in the affected side. . According to the patient’s condition, 3 to 4 weeks of repeated chemotherapy perfusion. Chemotherapy regimen: pirarubicin (THP), or adriamycin (ADR), or epirubicin (EADR) 50 to 70 mg/m2, carboplatin (CPB) 300 to 400 mg/m2, 5-fluoro Urea (5-Fu) 750 to 1 000 mg/m2, calcium folinate (CF) 100 to 200 mg. Results 32 patients in this group were followed up for 6 months to 7 years (mean 36 months), CR2 cases, PR25 cases, MR5 cases, total response rate (CR+ PR) 84.4 %; PR5 cases of 6 cases who had received systemic chemotherapy , MR1 cases; 2 cases of local radiotherapy were PR. Conclusion Intra-arterial infusion of chemotherapeutic drugs has positive significance for improving the survival rate of breast cancer, and it is still possible to achieve better results through arterial infusion in patients with systemic chemotherapy or local radiotherapy.