孙卫东，任普海，冯晓峰，郑永志，2.解放军第3医院消化内科，浙江宁波　35040；2.解放军92602部队医院内科，浙江宁波　3503

动脉介入化疗治疗结肠癌术后复发导致肠梗阻的疗效

孙卫东1，任普海1，冯晓峰1，郑永志1，2
1.解放军第113医院消化内科，浙江宁波315040；2.解放军92602部队医院内科，浙江宁波315031

目的 评价多西他赛、氟尿嘧啶及奥沙利铂经股动脉介入化疗治疗结肠癌术后复发导致肠梗阻的安全性及有效性。方法 自2012年1月—2015年12月，方便选取92例结肠癌术后复发导致肠梗阻的患者按随机数字表法平均分为2组，以动脉介入化疗为研究组，静脉化疗为对照组，所用药物为多西他赛、氟尿嘧啶及奥沙利铂，术后28 d评估疗效及安全性。结果 患者的肠梗阻改善情况：对照组显效2例、有效27例，研究组显效9例、有效34例，研究组疗效明显优于对照组；患者的主要症状（恶心呕吐、腹痛腹胀及排便排气）改善情况、血CEA的变化情况及患者生活质量评分，这些指标二组的差异均有统计学意义；而二组的不良反应差异无统计学意义。结论 多西他赛、氟尿嘧啶及奥沙利铂经动脉介入化疗治疗结肠癌复发导致肠梗阻的疗效优于静脉化疗，也是安全的。

多西他赛；氟尿嘧啶；奥沙利铂；肠梗阻；化疗

［Abstract］Objective To evaluate the safety and efficacy of docetaxel，fluorouracil and oxaliplatin arterial infusion chemotherapy treatment of intestinal obstruction caused by the recurred of colon cancer.Methods Convenient selection 92 cases of intestinal obstruction caused by the recurred of colon cancer were press randomly divided into two groups from January 2012 to December 2015.The study group received arterial infusion chemotherapy.The control group received intraperitoneal chemotherapy.All of them using with docetaxel fluorouracil and oxaliplatin.After 28 days to evaluate efficacy and adverse events.Results The obstruction to improve the situation：Significant effect in 2 cases，effect in 27 cases of control group，and significant effect in 9 cases，effect in 34 cases of study group.That of study group was significantly better than the control group.The differences of changes in nausea and vomiting，abdominal distension and pain，flatus and defection，blood CEA，changes in quality of life scores in patients between two groups were statistically significant.The difference between the two groups of adverse reactions were not statistically significant.Conclusion The effective of docetaxel，fluorouracil and oxaliplatin with arterial infusion chemotherapy was better than intraperitoneal chemotherapy.And it was safe.

［Key words］Docetaxel；Fluorouracil；Oxaliplatin；Intestinal Obstruction；Chemotherapy

随着社会的发展，结肠癌发病率越来越高，中国的发病率更是快速增长，外科手术切除仍是首选的治疗手段。然而，多达10%～30%患者术后会出现肿瘤复发导致肠梗阻，并且许多患者因为一般情况差，等无法耐受再次手术，这些患者往往经过内科常规治疗无法解除梗阻，严重影响患者的生活质量及生存期［1］。……