摘要
目的通过灌注治疗曲线定义腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)堵管事件,并探讨HIPEC过程中管路不通畅的原因。方法回顾性分析了2021年5月至2021年9月于华中科技大学同济医学院附属协和医院胃肠外科行HIPEC治疗的221例恶性肿瘤病人临床资料。通过HIPEC曲线对堵管事件及管路不通畅进行定义并分类,进而分析导致堵管事件发生和调整管路通畅难度增加的相关因素。结果221例病人共计完成了401例次HIPEC治疗,其中灌注治疗通畅214例次(53.4%),灌注过程中通过调整管路达到通畅136例次(33.9%),灌注不通畅51例次(12.7%)。多因素分析提示,相比于探查性质的手术,肿瘤根治性手术会增加HIPEC堵管事件的发生[OR=0.522,95%CI(0.281,0.969),P<0.05],而末端回肠造口是管路不通畅的独立危险因素[OR=1.052,95%CI(0.124,8.965),P<0.05]。结论HIPEC治疗过程中,肿瘤根治术是发生堵管事件的独立危险因素,而末端回肠造口会增加管路调整难度,导致灌注不通畅,应给予重视。
Objective To employ a perfusion curve for defining pipe blockage and exploring the causes of blockage events during hyperthermic intraperitoneal chemotherapy(HIPEC).Methods From May 2021 to September 2021,clinical data were retrospectively reviewed for 221 cancer patients receiving HIPEC.Through a perfusion chemotherapy curve,pipe blockage events were defined and classified.Then the related factors leading to the occurrence of pipe blocking events and the greater difficulty of adjusting pipe were analyzed.Results A total of 401 HIPEC were completed,including unobstructed(n=214,53.4%)were,unobstructed after adjusting pipeline(n=136,33.9%)and(n=51,12.7%).Multivariate analysis revealed that radical tumor resection boosted the occurrence of HIPEC blockage events[OR=0.522,95%CI(0.281,0.969),P<0.05]and ileostomy was an independent risk factor for impeded events[OR=1.052,95%CI(0.124,8.965),P<0.05].Conclusion During HIPEC,radical tumor resection is an independent risk factor for tube blockage events.And ileostomy enhances the difficulty of pipeline adjustment and causes poor perfusion.
作者
李源
王点石
林曜
曾新宇
沈楚
郭熙恺
吕剑波
陶凯雄
吴川清
Li Yuan;Wang Dianshi;Lin Yao;Zeng Xinyu;Shen Chu;Guo Xikai;Lyu Jianbo;Tao Kaixiong;Wu Chuanqing(Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430022,China)
出处
《腹部外科》
2023年第5期404-408,共5页
Journal of Abdominal Surgery
关键词
腹腔热灌注化疗
灌注治疗曲线
堵管事件
Hyperthermic intraperitoneal chemotherapy
Perfusion curve
Blockage events
