亚冬眠状态下全身热疗联合化疗治疗腹部晚期肿瘤

【目的】探讨亚冬眠状态下全身热疗联合化疗对腹部晚期肿瘤的有效加温时间及疗效、毒副作用。【方法】治疗组31例在给予加温前视情况加用镇静药物，酌情选用半量的人工冬眠Ⅰ、Ⅱ号或Ⅳ号合剂，及β受体阻滞剂，在用药30min后化疗与加温同步进行；对照组31例采用进行同步加热与化疗。两组直肠温度达到39．5℃后维持加温60～90min，最高温度不超过41．5℃，两组热化疗过程中使用热电偶监测鼓膜、加热区皮肤、直肠温度变化，同时进行全程心电监护。【结果】治疗组87．1％病人能够维持加温60～90min，其中66．1％超过90min；对照组维持加温时间60～90min者为66．1％，只有25．8％超过90min，两组比较差异有显著性（P〈0．001）；近期有效率治疗组77．4％，对照组51．6％，两组比较差异有显著性（P〈0．05）；治疗组心率增加低于对照组（P〈0．001）；两组病人均有皮肤反应，水疱发生，消化道反应与骨髓抑制均在Ⅱ级，无统计学意义。【结论】亚冬眠状态下实施全身亚高温热疗能增加维持加温时间，疗效优于非亚冬眠治疗；亚冬眠药物与β阻滞剂联用对心脏有保护作用，与化疗联合，毒副反应轻。

Clinical Observation of Sub-hyperthermal Therapy Combined Chemotherapy under Sub-hibernation for the Treatment of Advanced Abdominal Tumor

Objective] To explore the effective heating time, therapeutic effect and adverse reaction of sub-hyperthermal therapy combined chemotherapy under the condition of sub-hibernation for the treatment of advanced abdominal tumor. Methods]The treatment group（ n = 31） received the half-dose of artificial lytie cocktail Ⅰ , Ⅱ or Ⅳ and beta receptor antagonist, and 30 minutes later received sub-hyperthermal therapy combined chemotherapy. The control group（ n =31） received sub-hyperthermal therapy combined chemotherapy. The rectal temperature of the two groups arrived to 39. 5℃, and maintained 60-90 minutes, and the highest temperature was lower than 41. 5℃. At the same time, the thermocouple was used to monitor the changes of the temperature of diaphragma auris, skin in heated area and rectal, and ECG was used to monitor the entire progress of thermotherapy. Results]In the treatment group, the percentage of patients with main taining heating for 60-90min was 87.1%, and that of the maintaining heating for more than 90min was 66. 1%, but in the control group, the percentage of patients with maintaining heating for 60-90min was 66.1% and that of maintaining heating for less than 90min was 33.8%, and there was significant difference between the two groups （ P 〈0. 001）. The short-term effective rate in the treatment group was 77.4%, but that in the control group was 51.6%, and there was difference between the two groups（ P 〈0.05）. The degree of acceleration of heart rate in the treatment group was lower than that in the control group （ P 〈0. 001）. The incidence of skin reaction and bubble in two groups were similar. The gastrointestinal tract reaction and bone marrow depression in two groups were both in II degree, and there was no statistical significance. Conclusion] Systemic sub-hyperthermal therapy under sub hibernation can prolong maintaining heating time and has better effect than non-sub hibernation therapy. The sub-hibernation drugs plus beta-receptor antagonist can protect the heart, and both drugs combined with chemotherapy has light adverse reaction.