术中植入缓释氟尿嘧啶对肝癌术后转移复发的影响

目的:观察肝癌部分肝叶切除术后残肝断面植入5-氟尿嘧啶缓释剂(商品名:中人氟安)对肝癌转移复发的影响及其不良反应.方法:63例肝癌拟手术者随机分为两组:Ⅰ组(n=32)为普通化疗组,患者于肝癌肝叶部分切除术后行常规化疗;Ⅱ组(n=31)为缓释剂组,患者于肝癌肝叶部分切除术中残肝断面植入5-氟尿嘧啶缓释剂局部化疗.两组患者均随访一年,观察其不良反应、肿瘤复发率及患者死亡率.结果:术前两组患者肝功能无明显差异(P>0.05),术后Ⅱ组患者ALT、AST、TBL、PT、AFP水平均明显低于Ⅰ组(P<0.05);Ⅱ组患者术后复发转移率明显低于Ⅰ组(P<0.05);Ⅱ组患者的并发症发生率及死亡率均明显低于Ⅰ组患者(P<0.05).结论:术中残肝断面植入5-氟尿嘧啶缓释剂疗效明显,能够减少肿瘤复发和转移,增加患者的耐受性与依从性,可有效防止肝癌术后转移复发,值得临床推广应用.

The Effect of Implanting Sustained-release 5-Fluorouracil during Operation on Recurrence of Liver Cancer

Objective: To study the effect and adverse effect of implanting sustained-release 5-fluorouracil during hepatolobectomy to oppose metastasis of liver cancer.Method: 63 patients diagnosed with liver cancer were divided into two groups: group Ⅰ(n=32),ordinary chemotherapy group,patients with conventional chemotherapy after operation;group II(n=31),patients with sustained-release 5-fluorouracil during operation.Two groups were visited 1 year,observed the adverse effect,recurrence rate and death rate.Result: There’s significant difference in liver function before operation(P>0.05) of two groups.ALT,AST,TBL,PT,AFP in group II were much lower than group Ⅰ after operation(P<0.05);The recurrence and transferring rate of group II was much lower than group I(P<0.05);The incidence and mortality of group II were much lower than group Ⅰ(P<0.05).Conclusion: The treatment of sustained-release 5-fluorouracil during hepatolobectomy can effectively reduce the rate of transferring,recurrence and death of liver cancer patients,increase the patients’ compliance and tolerance,it may be a new therapy for patients with liver cancer after hepatectomy.