中晚期结直肠癌术中腹腔灌注雷替曲塞局部化疗不良反应评估

目的对中晚期结直肠癌术中腹腔灌注雷替曲塞局部化疗引起的不良反应进行评估。 方法选取2016年1月至2017年8月在南京医科大学康达学院附属涟水县人民医院治疗的40例中晚期结直肠癌手术的患者，分为观察组与对照组，观察组19例，对照组21例，观察组采用结直肠癌根治性手术＋术中腹腔灌注雷替曲塞，对照组采用常规结直肠癌根治性手术，术后2组患者均接受6个疗程化疗及巩固性放疗。采用独立样本t检验比较观察组与对照组血液系统指标、手术时间及住院时间的差异，采用ANOVA方差检验比较手术前后的差异；采用χ²检验比较2组患者术后并发症、骨髓抑制等方面的差异。 结果观察组患者术后白细胞计数稍增高，而对照组术后白细胞计数稍有下降，但2组间比较差异无统计学意义（P>0.05）；2组患者除术后4周的血小板计数稍有增高外，其余术后的血小板计数均较术前稍有降低，2组比较差异均无统计学意义（P>0.05）；2组患者术后血红蛋白浓度较术前均有所降低，但2组比较差异均无统计学意义（P>0.05）；观察组患者术后肝功能未见异常变化，对照组患者术后肝功能稍有增高，但2组比较差异无统计学意义（P>0.05）；2组患者肾功能水平术后较术前均稍有增高，但组间比较差异无统计学意义（P>0.05）；2组患者白细胞、血小板、血红蛋白、肝功能、肾功能术前与术后比较差异均无统计学意义（P>0.05）。2组患者手术及住院时间比较差异无统计学意义（P>0.05）。2组患者术后并发症比较差异均无统计学意义（P>0.05）。观察组与对照组患者术后均未出现重度骨髓抑制。 结论中晚期结直肠癌术中腹腔灌注雷替曲塞化疗是可行且安全的，其操作简单且患者能耐受。

Adverse effects of intraoperative infusion of Raltitrexed in patients with advanced colorectal cancer

ObjectiveTo evaluate the adverse effects of intraoperative chemotherapy with retetroxacin in patients with advanced colorectal cancer. MethodsForty patients with locally advanced colorectal cancer who underwent surgical treatment from January 2016 to August 2017 at Lianshui First People's Hospital Affiliated to Institute of Kangda of Nanjing Medical University were selected and divided into either an observation group (19 cases) or a control group (12 cases). The observation group underwent radical surgery plus intraoperative perfusion of retetroxacin, and the control group underwent radical surgery alone. Both groups of patients received six cycles of chemotherapy and consolidation radiotherapy. Hematological system indexes, operation time, and hospitalization days were compared between the two groups by the independent sample t-test. ANOVA was performed to compare preoperative and postoperative differences. Age, sex, tumor site, postoperative complications, and bone marrow suppression were compared by the χ² test. ResultsThe number of postoperative leukocytes slightly increased in the observation group, and slightly decreased in the control group, but the difference between the two groups was not statistically significant (P>0.05). Except for a slight increase in the number of platelets at 4 weeks after the operation, the number of platelets in the two groups was slightly lower than that before the operation, and the difference between the two groups was not statistically significant (P>0.05). The postoperative levels of hemoglobin in the two groups were lower than those before the operation, but the difference between the two groups was not statistically significant (P>0.05). Postoperative liver function indexes of patients in the observation group showed no abnormal changes, while patients in the control group showed a slight increase in postoperative liver function indexes, but the difference between the two groups was not statistically significant (P>0.05). Renal function indexes of the two groups increased slightly after surgery compared with those before surgery, but the difference between the two groups was not statistically significant (P>0.05). Compared with preoperative values, there was no significant difference in the postoperative values of WBC, platelets, hemoglobin, liver function, or renal function (P>0.05). There was no significant difference in operative time or postoperative complications between the two groups (P>0.05). No severe myelosuppression was observed in either group. ConclusionIt is feasible and safe to use intraoperative Raltitrexed chemotherapy in patients with advanced colorectal cancer.