缓释氟尿嘧啶在胃肠恶性肿瘤术中的应用

[目的]探讨区域性缓释化疗在消化道恶性肿瘤中的疗效。[方法]68例胃肠肿瘤患者随机分为两组：治疗组38例，术中使用植入缓释氟尿嘧啶；对照组30例，术中未使用缓释氟尿嘧啶。两组临床病理资料具有可比性。[结果]使用植入缓释氟尿嘧啶治疗组未出现明显的胃肠道反应。治疗组吻合口瘘1例、肠梗阻1例、腹腔化脓性感染1例；而对照组吻合口瘘1例、肠梗阻1例、无腹腔化脓性感染。两组并发症发生率比较无统计学差异（7．9％vs6．7％，χ^2=0．037，19=0．847）。治疗组2年局部复发率为5．3％，而对照组2年局部复发率为23.3％（χ^2=0．060，P=0．027）；两组2年无远处转移率无统计学差异（χ^2=0．060，P=0．807）。治疗组与对照组术后2年生存率分别为94．7％和76．7％（P〈0．05）。[结论]术中植入缓释氟尿嘧啶安全、可行，可降低胃肠肿瘤术后复发率及提高术后生存率．具有一定的临床应用价值。

Application of Sustained-release Fluorouracil in Patients with Gastrointestinal Cancer

[Purpose] To investigate the effect of regional release chemotherapy in gastrointestinal cancer. [Methodsl A total of 68 cases with gastrointestinal cancer were randomly divided into two groups：38 cases as treatment group accepted fluorouracil sustained release implant intraoperatively, and 30 cases without fluorouracil sustained release as control group. Clinical and pathological data in the two groups were comparable. [Results] Severe gastrointestinal toxicity was not found in treatment group. One case occurred anastomotic leak;1,intestinal obstruction and 1,abdominal purulent infection in the treated group;While 1 case of anastomotic leak and 1 case of intestinal obstruction were observed in control group. The rate of complications was not significant in the two groups （7.9% vs 6.7%,χ2=0.037,P=0.847）. The 2-year local recurrence rate in treatment group was 5.3%, and 23.3% in control group＇s （χ^2=0.060,P=0.027）. The 2-year distant metastasis rate showed no significant difference between two groups （χ^2=0.060,P=0.807）. The 2-year survival rate was 94.7% in treatment group and 76.7% in control group （P〈0.05）. [Conclusion] Fluorouracil sustained release implant intraoperatively is safe and feasible,which might reduce recurrence rate and improve survival rate in patients with gastrointestinal cancer.