摘要
目的观察脑胶质瘤手术创伤对顺铂通过血-脑脊液屏障的影响,探讨术中使用化学药物治疗脑胶质瘤的可行性和安全性。方法 24例行脑胶质瘤切除术患者分为术前给药组和术中给药组,每组12例,术前给药组患者于麻醉开始时静脉泵入顺铂,持续30 min,泵入顺铂结束30 min后打开硬脑膜,取血浆、肿瘤组织、肿瘤周围组织及脑脊液标本;术中给药组患者于切硬脑膜同时静脉泵入顺铂,持续30 min,泵入顺铂结束后30 min、肿瘤全切除前,取血浆、肿瘤组织、肿瘤周围组织及脑脊液标本。应用高效液相色谱法检测标本中顺铂的质量浓度,并在第1个化学治疗周期后进行短期药物毒副作用评价。结果 2组患者血浆和肿瘤组织中顺铂质量浓度比较差异均无统计学意义(P>0.05);术中给药组患者脑脊液和肿瘤周围组织中顺铂质量浓度显著高于术前给药组(P<0.05)。术前给药组和术中给药组患者不良反应发生率分别为33.3%和25.0%,2组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论手术创伤能导致血-脑脊液屏障通透性开放,术中化学治疗能显著增加肿瘤周围组织及脑脊液中的药物浓度。脑胶质瘤患者术中化学治疗具有可行性和安全性。
Objective To observe the influence of the operation of brain glioma on cisplatin through the blood-cerebrospinal fluid barrier,and to explore the feasibility and safety of the intraoperative chemotherapy for brain glioma.Methods Twenty-four patients who underwent cerebral hemisphere glioma resection were divided into preoperative medication group and intraoperative medication group,12 cases in each group.Cisplatin was used by intravenous infusion within 30 minutes when the start of anesthesia in preoperative medication group.Thirty minutes after the end of cisplatin infusion,the cerebral dura mater was dissected.Then the blood plasma,tissues of tumor,peritumoral tissues and cerebrospinal fluid were collected.In intraoperative medication group,cisplatin was used by intravenous infusion within 30 minutes when the cerebral dura mater was dissected.Thirty minutes after the end of cisplatin infusion,the blood plasma,tissues of tumor,peritumoral tissues and cerebrospinal fluid were collected.The mass concentration of cisplatin in the samples was detected by high performance liquid chromatography.The shortterm toxic and side-effects of drugs were evaluated after the first chemotherapy cycle.Results There was no significant difference in the concentration of cisplatin in plasma and tumorous tissues between the two groups（P 〈0.05）.The concentration of cisplatin in cerebrospinal fluid and peritumoral tissues in intraoperative medication group was significantly higher than that in preoperative medication group（P 〈0.05）.The rate of adverse reaction in preoperative medication group and intraoperative medication group was 33.3% and 25.0% respectively,there was no significant difference in the rate of adverse reaction between the two groups（P 〉0.05）.Conclusions Operation wound can open the blood-cerebrospinal fluid barrier permeability.Intraoperative chemotherapy can significantly increase the drug concentration of peritumoral tissues and cerebrospinal fluid.Intraoperative chemotherapy is feasible and safe in
出处
《新乡医学院学报》
CAS
2015年第1期51-53,共3页
Journal of Xinxiang Medical University
关键词
脑胶质瘤
血-脑脊液屏障
术中化学治疗
gliotoma
blood-cerebrospinal fluid barrier
intraoperative chemotherapy
