三种不同置管方式腹腔热灌注化疗的流速和温度比较的动物实验

目的:通过动物实验比较外科手术置管和内科腹腔穿刺置管在腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)中灌注流速和体腔内温度的差异。方法:将10头家猪随机分至A、B、C三组，A组采用四点法外科式HIPEC，B组采用两点法内科式HIPEC，C组在前30 min采用两点法内科式HIPEC，后30 min采用四点法内科式HIPEC，所有动物均在左下腹、左上腹、右下腹、右上腹留置腔内测温器，记录每个测温点的初始温度，在HIPEC的第15、30、45、60 min记录灌注液的流速和温度，并在术中和术后监测实验动物的生命体征。结果:采用重复测量方差分析比较三组的流速和温度，差异均无统计学意义(P=0.214、0.305)。将三组的流速和温度进行两两比较，在15、60 min时A、C两组的流速差异有统计学意义（P＜0.05），其余时间点三组的流速差异均无统计学意义(P＞0.05)；A、B两组在45、60 min时的温度差异有统计学意义（P＜0.05），B、C两组在30 min时的温度差异有统计学意义（P＜0.05），其余时间点三组的温度差异均无统计学意义(P＞0.05)。所有动物在HIPEC过程中的生命体征平稳，术后恢复良好。结论:尽管内科式HIPEC的引流管更细，B组的两点法内科式HIPEC和C组的四点法内科式HIPEC均可达到A组的外科式HIPEC的流速及温度水平，且创伤更小，重复性更好，值得临床推广。

Animal experiment on the comparison of flow velocity and temperature of hyperthermic intraperitoneal chemotherapy with three different methods

Objective:To compare the difference of flow velocity and temperature between surgical catheterization and abdominal puncture catheterization in hyperthermic intraperitoneal chemotherapy(HIPEC).Methods:Ten pigs were randomly divided into groups A,B and C.Group A was treated with four-point surgical HIPEC,and group B was treated with two-point internal medicine HIPEC.Group C was treated with two-point internal medicine HIPEC in the front 30 minutes,and four-point internal medicine HIPEC in the post-30 minutes.In all animals,intracavitary thermometers were placed in the left lower abdomen,left upper abdomen,right lower abdomen and right upper abdomen,and the initial temperature of each point was recorded.The flow velocity of perfusion fluid and the temperature of each point were recorded at 15,30,45 and 60 minutes of HIPEC,and the vital signs of the experimental animals were monitored during and after operation.Results:The flow velocity and temperature of the three groups were compared by repeated measurement analysis of variance,and there was no significant difference among the three groups (P=0.214,0.305).There was significant difference in flow velocity between group A and group C at 15 and 60 minutes (P＜0.05),but there was no significant difference among the three groups at other time points.There was significant difference in temperature between group A and group B at 45 and 60 minutes,and between group B and C at 30 minutes (P＜0.05).There was no significant difference in temperature among the three groups at other time points (P＞0.05).The vital signs of all animals were stable during the operation and recovered well after operation.Conclusion:Although the drainage tube of internal medical HIPEC is thinner,two-point internal medical HIPEC in group B and four-point internal medical HIPEC in group C can reach the flow velocity and temperature level of surgical HIPEC in group A,with less trauma and better repeatability,which is worthy of clinical promotion.