体腔循环热灌注化疗的安全性实验研究

  目的   观察体腔循环热灌注化疗(Cavity circulatorythermal perfusion, CCTP)中不同温度对实验犬生命体征和腹腔各脏器的影响, 明确实验动物CCTP的适宜温度。   方法   以犬为实验动物, 分别于其腹腔温度41、42、43℃时进行指标检测。对每组动物进行CCTP, 化疗药物为顺铂, 每次流速140mL/min治疗持续60 min, 每隔2 d重复1次, 共3次。在每次CCTP前及24 h后抽取外周血备检。CCTP 3次后24 h及2周时每组分别处死2只犬, 观察内脏器官形态学改变, 进行肝、肾等脏器病理检查。   结果   41、42℃温度, 流速140mL/min下3次CCTP对犬的生命体征及肝肾功无明显影响; 43℃腹腔温度流速140mL/min行3次CCTP后对犬生命体征及肝肾功有不同程度的影响, 肝、肾、脾及肠组织表现出病理损伤。   结论   42℃、流速140mL/min以下腹腔温度联合顺铂3次CCTP、每次60 min是安全的, 可作为CCTP联合化疗的治疗温度; 43℃同条件下对犬的生理功能有损害, 不适合作为CCTP联合化疗的治疗温度。 

Experimental Study on the Safety of Abdominal Cavity Circulatory Thermal Perfusion

  Objective   This work investigated the effect of cavity circulatory thermal perfusion (CCTP) on the vital signs and important organs of the experimental animal dogs at different temperatures. The study likewise aimed to determine the optimal temperature for chemotherapy.   Methods   Dogs were used as the experimental animal models for CCTP. CCTP was performed with cisplatin using a hyperthermic intraperitoneal treatment system at 41℃, 42℃, and 43℃ (one course of clinical treatment). The hepatic and renal functions were detected in preserved blood samples before CCTP and at 24 h after each course of the treatment. The respective morphological and pathological changes of the major abdominal organs were likewise studied at 24 h as well as 2 weeks after the third course of CCTP.   Results   The three courses of CCTP with a perfusion rate of 140 mL/min at 41 or 42℃ did not have any observable negative effects on the hepatic and renal functions of experimental animals. On the other hand, the three courses of CCTP with a perfusion rate of 140 mL/min at 43℃ had a significant negative effect on the hepatic and renal functions, with histopathological injuries in the liver, kidney, spleen, and intestines.   Conclusion   CCTP with a perfusion rate of 140 mL/min combined with cisplatin chemotherapy (three times /60 min) was safe and feasible at 42℃, but could damage visceral organs of experimental animals at 43℃.