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目的:观察老年结直肠癌患者术后辅助化疗的安全性。方法:将老年结直肠癌60例随机分为观察组34例和对照组26例。对照组术后按照常规方法治疗;观察组在对照组治疗的基础上,于术后第5天开始采用FOLFOX4方案进行辅助化疗。比较两组术后切口、吻合口愈合和胃肠道功能恢复情况,白细胞计数、T细胞变化,以及不良反应发生情况等。结果:两组术后不同时间点节点白细胞计数差异不显著(P>0.05)。两组术后第7天CD4+和CD4+/CD8+水平均显著低于术前(P<0.05),CD8+水平显著高于术前(P<0.05);两组间比较,差异不显著(P>0.05)。术后切口、吻合口愈合时间,术后首次排气时间和胃肠道功能恢复情况,两组比较差异不显著(P>0.05)。观察组出现轻度恶心、呕吐8例,发生率23.5%;对照组未发生恶心、呕吐。结论:采用FOLFOX4方案辅助化疗仅出现轻度恶心、呕吐,不影响患者切口、吻合口愈合,以及免疫功能和胃肠道功能的恢复。
Objective: To observe the safety of postoperative adjuvant chemotherapy in elderly patients with colorectal cancer. Methods: 60 elderly patients with colorectal cancer were randomly divided into observation group 34 cases and control group 26 cases. The control group was treated by conventional method after operation. The observation group received adjuvant chemotherapy with FOLFOX4 regimen on the fifth day after the operation in the control group. The incision, anastomotic healing and gastrointestinal function recovery, white blood cell count, T cell changes, and the incidence of adverse reactions were compared between the two groups. Results: There was no significant difference in the number of leukocytes between two groups at different time points (P> 0.05). The levels of CD4 + and CD4 + / CD8 + on the 7th day after operation were significantly lower than those before operation (P <0.05), while the levels of CD8 + were significantly higher than those before operation (P <0.05) ). Postoperative incision, anastomotic healing time, the first postoperative exhaust time and gastrointestinal function recovery, the difference between the two groups was not significant (P> 0.05). The observation group showed mild nausea and vomiting in 8 cases, the incidence rate was 23.5%. The nausea and vomiting did not occur in the control group. CONCLUSIONS: FOLFOX4 adjuvant chemotherapy only mild nausea and vomiting, does not affect the incision, anastomotic healing, and immune function and gastrointestinal function recovery.