术中腹腔氟尿嘧啶缓释剂留置方式对进展期胃癌患者预后影响及安全性

目的 探讨术中腹腔氟尿嘧啶缓释剂留置方式对进展期胃癌患者预后的影响及安全性.方法 选择2008年6月～2012年4月我院术中腹腔植入氟尿嘧啶缓释剂游离留置32例（A组）,术中植入氟尿嘧啶缓释剂表面包覆留置35例（B组）,未采用腹腔内氟尿嘧啶缓释剂植入30例（C组）,分析术后外周血T细胞亚群改变,不良反应及1、2、3年生存率、复发率、转移率.结果 A组和B组术后CD3＋T细胞、CD4＋T细胞占比及CD4＋/CD8＋均呈减少趋势（P＜0.05）,A组减少较B组更为显著,A组CD3＋T细胞、CD4＋T细胞占比及CD44＋CD8＋术后1、3、7d均显著低于C组（P＜0.05）,B组仅CD3＋T细胞术后1天显著低于C组（P＜0.05）.三组不良反应比较差异均无统计学意义（P＞0.05）.2、3年A组和B组生存率显著高于C组,复发率、转移率显著低于C组（P＜0.05）,A组和B组1、2、3年生存率、复发率、转移率差异无统计学意义（P＞0.05）.结论 术中腹腔氟尿嘧啶缓释剂植入可有效提高患者远期生存率降低复发和转移率,植入氟尿嘧啶缓释剂表面包覆留置方式可减少对免疫功能的抑制作用,安全性较好.

Peritoneal catheter fluorouracil sustained release manner prognosis and safety of patients with gastric cancer advanced

Objective To study the peritoneal catheter fluorouracil sustained release manner prognosis of patients with advanced gastric cancer and security. Methods June 2008 to April 2012 in our hospital peritoneal implants fluorouracil release agent free indwelling 32 cases （A group ） , intraoperative fluorouracil sustained release implant coated catheter 35 cases （B group ） did not use the intraperitoneal fluorouracil sustained release implant 30 cases （C group）, after analyzing changes in peripheral blood T cell subsets, adverse reactions and 3-year survival, rectlrrence rate, the transfer rate. Results A group and B group were CD3＋ T cells, CD4＋ T cell percentage and CD4＋ / CDs＋ showed a decreasing trend （P〈0.05）, A group decreased more significantly than in group B , A group CD3＋ T cells, CD4＋ T cell percentage and CD4＋ / CD8＋ 1,3,7 days after surgery were significantly lower than in group C （P〈0.05）, B group, only CO3＋ T cells was significantly lower after one day in group C （P〈0.05）. Adverse reactions compared three groups showed no significant difference（P 〉0.05）. 2,3 years survival rate in group A and group B were significantly higher than in group C, the recurrence rate, metastasis rate were significantly lower in group C （P〈O.05）, A group and B group and 3-year survival , recurrence rate , metastasis rate were no significant difference （P 〉0.05）. Conclusion Intraoperative peritoneal fluorouracil sustained release implant can effectively improve the long-term survival in patients with reduced rates of recurrence and metastasis, fluorouracil sustained release implant coated indwelling ways to reduce the inhibitory effect on immune function, better security.