顺铂腹腔注入治疗卵巢癌腹水的临床观察

晚期卵巢癌腹水的治疗相当困难,目前虽有一些治疗卵巢癌腹水的方法,但用顺铂腹腔内注入治疗卵巢癌腹水尚未见报道。我们在术前和术中用顺铂(各100mg)腹腔注入治疗20例晚期卵巢癌腹水患者。所有患者的全身状况在术前均得到明显改善,19例上皮性卵巢癌腹水患者一年内无腹水生长。该方法简单、安全,控制腹水生长效果明显,副作用少。     

实验性小肠动脉出血的垂体后叶素灌注治疗

经动脉导管灌注垂体后叶素治疗１０条犬小肠出血的实验研究结果表明，垂体后叶素灌注治疗的效果与出血部位累及的血管大小及出血速率有关。还提示垂体后叶素对较大血管引起的出血灌注治疗无效，其引起血管的收缩作用主要在末梢小血管。     

术前动脉灌注化疗加乳腺区段切除治疗乳腺癌的探讨

目的　探索早期乳腺癌保留乳房治疗的新途径。方法　 1995 - 1997年采用术前动脉插管化疗加乳腺区段切除治疗Ⅰ、Ⅱ期乳腺癌共 2 6例 ,并随访 5年以上。结果　 2 6例中 1例术后 2年 4个月死于肺转移 ,另 1例术后 4年死于其他疾病。 1例术后 1年复发 ,行全乳房切除后至今无瘤生存 6年。本组 3年生存率 (OS) 96 .15 % ,3年无瘤生存率 (DFS) 92 .3% ;5年OS 88.4 6 % ,5年DFS 88.4 6 %。结论　术前动脉插管化疗能提高肿瘤区域的药物浓度 ,杀灭部分癌细胞 ,减少术后复发。该疗法对部分Ⅰ、Ⅱ期乳腺癌病例是可行的。     

胆囊切除术引流与不引流200例临床分析

胆囊切除术后是否行腹腔引流，外科医生意见不一．本文通过对２００例胆囊切除术的对比分析，总结了“引流”与“不引流”的利弊和经验。认为择期单纯胆囊切除不必常规放置引流，但对手术后有可能发生出血、胆漏的病例，在放与不放引流犹豫不决时，仍以放置引流为妥．本文同时提出了胆囊切除术引流与不引流的适应症．     

LONG-TERM OUABAIN ADMINISTRATION DOES NOT ALTER BLOOD PRESSURE IN CONSCIOUS SPRAGUE-DAWLEY RATS

1. We tested the ability of ouabain to cause chronic hyper tension by continuously infusing ouabain for 28 days (mini-osmotic pump implantation; i.p.). The blood pressure and metabolic effects of sham (150 mmol/L NaCI; n= 12) or ouabain infusion (10 μg/kg per day; n= 14; 100 μg/kg per day; n = 14) were examined in conscious Sprague-Dawley rats. 2. Plasma ouabain concentrations measured after 28 days of ouabain infusion were as follows: sham, not detectable (n= 11); ouabain 10 μg/kg per day, 0.60 ± 0.07 nmol/L (n= 14); and ouabain 100 μg/kg per day, 7.17 ± 0.57 nmol/L (n= 14; P < 0.001). 3. Sham or ouabain infusion did not alter food intake, bodyweight, water intake or urine output in conscious rats. 4. Blood pressure was not altered by sham treatment. Ouabain at 10 μg/kg per day or 100 μg/kg per day did not produce consistent rises in blood pressure. Ouabain at 10 μg/kg per day increased blood pressure on treatment day 12 only (+ 6mmHg; P < 0.05), while at 100μg/kg per day blood pres sure increased on treatment days 16 (+ 9 mmHg; P < 0.05) and day 18 (+ 8mmHg; P < 0.05) only. There was no significant difference in blood pressure between sham and ouabain groups. 5. Renal blood flow was decreased in rats infused with ouabain at 10 μg/kg per day (2.0 ± 0.3 mL/min per 100 g body-weight; n= 5; P < 0.01) and 100 μg/kg per day (2.2 ± 0.4 mL/ min per 100 g bodyweight; n= 7; P < 0.05) compared with sham treatment (3.5 ± 0.2 mL/min per 100 g bodyweight; n= 6). Renal vascular resistance was increased in rats treated with ouabain at 10 μg/kg per day (65.5 ± 12.6 mmHg/mL per min per 100 g bodyweight; n= 5; P < 0.01) and 100 μg/kg per day (66.0 ± 15.6 mmHg/mL per min per 100 g bodyweight; n= 7; P < 0.05) compared with sham treatment (32.6 ± 2.5 mmHg/mL per min per 100 g bodyweight; n= 6). 6. High plasma concentrations of ouabain do not cause consistent increases in blood pressure in conscious Sprague-Dawley rats.     

全植入式药泵行肝血管灌注治疗晚期肝癌

对２４例不能切除的晚期肝癌采用完全植入式药泵行肝动脉和门静脉双灌注化疗。结果：部分缓解（ＰＲ）１５例（６２．５％），稳定（Ｓ）８例（３３．３％），进展（Ｐ）１例。平均生存期为９．１７月，半年生存率为６６．７％，１年为２５％。在ＡＦＰ＞４００μｇ／Ｌ的１０例中，５例下降。     

Use of acute peritoneal dialysis catheters for intraperitoneal chemotherapy instead of the semipermanent/permanent Tenkhoff catheters

Intraperitoneal chemotherapy was administered to 13 patients with peritoneal carcinomatosis, using acute peritoneal dialysis catheters immediately before the administration of the chemotherapy. A total of 59 cycles were administered, with insertion of the corresponding catheter. There were no inflow or outflow problems and no insertion-related complications. With the removal of the catheter after its use, there is no risk of abdominal infections.     

异丙酚及氯胺酮靶控输注全静脉麻醉临床应用

目的　研究异丙酚复合不同镇痛剂量氯胺酮靶控输注全静脉麻醉临床应用的可行性及对血流动力学、麻醉恢复的影响。方法　择期手术患者 80例 ,分别采用异丙酚 (P组 ,n =16)及复合氯胺酮血药浓度 0 2 0mg/L(PK1组 ,n =16) ,0 40mg/L(PK2 组 ,n =16) ,0 60mg/L(PK3 组 ,n =16)和 0 80mg/L(PK4组 ,n =16)全静脉麻醉 ,采用微机控制Graseby 3 5 0 0输液泵靶控输注异丙酚或氯胺酮 ,连接Aspect-A10 0 0型脑电监护仪监测脑电变化 ,观察两组患者血流动力学改变及麻醉恢复情况。结果　单用异丙酚患者随着异丙酚血药浓度升高脑电双频指数 (BIS)值降低 ,呈明显负相关 (P <0 0 5 ) ,氯胺酮血药浓度从 0 2 0mg/L增至 0 80mg/L ,BIS值无明显变化 (P >0 0 5 )。与P组相比 ,PK1,PK2 ,PK3 ,PK4组异丙酚用量减少约 15 %～ 40 % ,PK4组停药至睁眼时间明显延长 ,其余各组无明显差异 (P >0 0 5 )。术中P ,PK1组收缩压、舒张压升高 ,PK2 ,PK3 ,PK4组无明显改变。术后无躁动、不良回忆等并发症。结论　异丙酚复合镇痛剂量的氯胺酮 (0 40～ 0 60mg/L)靶控输注全静脉麻醉具有血流动力学稳定、减少异丙酚用量、无明显术后并发症等优点。