| 腹腔灌注化疗治疗恶性腹水有效性和安全性的系统性研究 |
| Alternative Title | A Systemic Study of The Effectiveness and Safety in the Treatment of Intraperitoneal Chemotherapy for Malignant Ascites Patients
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| 李丹丹 |
| Thesis Advisor | 米登海
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| 2015-05-20
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 恶性腹水
腹腔灌注化疗
腹腔热灌注化疗
Meta分析
回顾性临床对照研究
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| Abstract | 目的：比较腹腔热灌注化疗、常温腹腔灌注化疗、静脉化疗治疗恶性腹水的疗效和安全性，为临床决策提供证据参考、为提高患者生活质量提供帮助。
方法：检索国内外数据库，收集腹腔热灌注化疗对比常温腹腔灌注化疗治疗恶性腹水的RCT，用RevMan5.3软件进行Meta分析；用回顾性临床对照方法，比较热灌注化疗、常温灌注化疗和静脉化疗三种方案治疗恶性腹水的疗效和安全性，用SPSS19.0软件进行分析。
结果：共纳入21个RCT，1360例患者。Meta分析显示：热灌注组1年生存率、近期疗效高于常温组；安全性无明显差异。回顾性临床对照研究显示：热灌注组（A组）总有效率高于常温灌注组(B组)和静脉化疗组(C组)；各组治疗前后及A、B组，B、C组治疗后腹胀程度、腹围情况差异有统计学意义。各组治疗前后，及A、B组治疗后腹水深度情况差异均具有统计学意义。A、C组治疗后腹水涂片癌细胞转阴率、白细胞降低、骨髓抑制情况比较差异具有统计学意义。B、C组骨髓抑制情况比较差异均具有统计学意义，三组其他不良反应比较无统计学意义。
结论：本研究显示腹腔热灌注化疗与其他两种疗法安全性相似，疗效更加显著。但本研究尚有一定局限性，需大样本的前瞻性随机对照研究的深入验证。 |
| Other Abstract | Objective: Malignant ascites is a common complication in the middle or late period of the abdominal and extra-abdominal neoplasms. Once vast advanced peritoneal seeding occur, patients would lose the opportunity to undergo surgery. In addition, the prognosis is extremely poor and the survival time is generally as low as less than 2 months. Treatment options include a multitude of different procedures, such as medical, interventional and surgical treatments ,but all have limited efficacy , some degree of risks and Side effects. As a palliative treatment, intraperitoneal chemotherapy(IPC) is gradually drawing people's attention because of its effectiveness in the treatment of malignant ascites reported in some sino-foreign literatures. However, there is no generally accepted management guidelines of IPC（include normothermic IPC and HIPEC）, and compared with systemic chemotherapy, its’ effectiveness and safety lack the support of systematical and evidence-based clinical trials. Our study uses the Evidence-based Medicine (EBM) methods to assess the effectiveness and safety of normothermic IPC vs HIPEC to treatment malignant ascites, then based on the systematic review, using the retrospective clinical trial research the three groups and do statistic analysis on the data. Thus providing evidence for clinical decision-making , and to help improve the quality of life of patients.Methods: The randomized controlled trials (RCTs) comparing hyperthermic intraperitoneal chemoperfusion therapy and normothermic intraperitoneal chemoperfusion therapy for malignant ascites were collected by computer-based search in the national and international online databases, such as PubMed, EMBASE, Cochrane Library, Web of Science, VIP Database, Chinese Biomedical Literature Database(CBM), China Journal Full-Text Database(CNKI), Wanfang Database, and references of the included studies up to January 2015. The quality of the included studies was evaluated by Cochrane Handbook recommended standard. Data were analyzed by RevMan 5.3 from the Cochrane Collaboration. Using the retrospective research way and according to the WHO standards objectively evaluate the respective efficacy and safety of the three methods. Statistical analyses are performed with SPSS software version 19.0.Results: 21 RCT were absorbed, including 1360 patients. The results of Meta-analysis showed that compared with normothermic intraperitoneal chemoperfusion therapy , HIPEC is higher on the one year survi... |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223553
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
李丹丹. 腹腔灌注化疗治疗恶性腹水有效性和安全性的系统性研究[D]. 兰州. 兰州大学,2015.
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