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目的探讨胃癌根治术加植入缓释氟尿嘧啶(中人氟安)治疗Ⅲ期胃癌的效果及可行性。方法回顾分析南昌大学第一附属医院2008年12月至2009年11月188例Ⅲ期胃癌临床资料。188例均行胃癌根治术,术中随机分为2组:A:治疗组,术中使用植入缓释氟尿嘧啶,96例;B:对照组,不植入缓释氟尿嘧啶,92例。术后4周均采用静脉化疗,并作随访观察。结果与B组比较,使用植入缓释氟尿嘧啶患者腹腔引流液多,其中78.1%有腹痛、31.2%低热,且腹痛、低热持续的时间均长于对照组(P<0.05),但无其他明显毒副作用。治疗组与对照组相比术后1年内复发率(6.30%∶16.30%)和死亡率(3.02%∶10.87%)均有显著性差异(P<0.05)。结论术中植入缓释氟尿嘧啶安全、可行,可降低Ⅲ期胃癌术后复发率及提高术后生存率,具有一定的临床应用价值。
Objective To investigate the efficacy and feasibility of radical gastrectomy combined with implantation of sustained-release fluorouracil for the treatment of stage Ⅲ gastric cancer. Methods The clinical data of 188 cases of stage Ⅲ gastric cancer from December 2008 to November 2009 in the First Affiliated Hospital of Nanchang University were retrospectively analyzed. All 188 patients underwent radical gastrectomy. The patients were randomly divided into 2 groups: A: treated group, 96 patients were treated with sustained-release fluorouracil during operation; B: control group, 92 patients were not treated with sustained-release fluorouracil. After 4 weeks of intravenous chemotherapy, and for follow-up observation. Results Compared with group B, patients with sustained-release fluorouracil had more peritoneal drainage fluid, of which 78.1% had abdominal pain and 31.2% had low fever, and the duration of abdominal pain and hypothermia was longer than that of the control group (P <0.05) side effect. The recurrence rate (6.30%: 16.30%) and mortality (3.02%: 10.87%) in the treatment group and the control group within one year after operation were significantly different (P <0.05). Conclusion Intraoperative implantation of sustained-release fluorouracil is safe and feasible, which can reduce postoperative recurrence rate and improve postoperative survival rate of stage Ⅲ gastric cancer, and has certain clinical value.