Fujimoto S, Kokubun M, Shrestha R D, Kobayashi K, Kiuchi S, Konno C, Takahashi M, Okui K
First Department of Surgery, School of Medicine, Chiba University, Japan.
Int J Hyperthermia. 1991 Jul-Aug;7(4):543-50. doi: 10.3109/02656739109034966.
In attempts to avoid the side-effects derived from a scald on the peritoneo-serosal surface during intraperitoneal hyperthermic perfusion (IPHP) for advanced gastric cancer, a randomized study using cimetidine, a histamine H2-receptor antagonist, was carried out on 18 patients with advanced gastric cancer. Cimetidine, 50 mg/kg, was administered intravenously and immediately before IPHP. The background characteristics of the patients and the types of surgical treatment used were almost the same between each group of patients, whether or not cimetidine was given. The perfusion time in the cimetidine and control groups was 123 +/- 9 and 117 +/- 9 min, respectively. The inflow and outflow temperatures of the perfusate were 46.3 +/- 0.4 and 44.2 +/- 0.1 degrees C in the cimetidine group, respectively, whereas in the control group the temperatures were 46.0 +/- 0.3 and 44.1 +/- 0.2 degrees C, respectively. In the nine patients who were given cimetidine, the histamine concentrations in the peripheral blood increased significantly, compared to those in the nine controls; this resulted from the release of histamine into the circulating blood. Higher concentrations of protein were observed in the post-hyperthermic intraperitoneal exudate of the control group for 3-24 h after IPHP and, consequently, post-hyperthermic hypoproteinaemia was remarkable in the control group. These data suggest that when pre-IPHP cimetidine was prescribed for patients with gastric cancer treated with IPHP, the peritoneo-serosal surface was protected from scald injury and the side-effects of IPHP were reduced.
为避免晚期胃癌腹腔内热灌注（IPHP）过程中腹膜浆膜表面烫伤产生的副作用，对18例晚期胃癌患者进行了一项使用组胺H2受体拮抗剂西咪替丁的随机研究。在IPHP前即刻静脉注射50mg/kg西咪替丁。无论是否给予西咪替丁，每组患者的背景特征和所采用的手术治疗类型几乎相同。西咪替丁组和对照组的灌注时间分别为123±9分钟和117±9分钟。西咪替丁组灌注液的流入和流出温度分别为46.3±0.4℃和44.2±0.1℃，而对照组的温度分别为46.0±0.3℃和44.1±0.2℃。与9名对照组患者相比，9名接受西咪替丁治疗的患者外周血中的组胺浓度显著升高；这是由于组胺释放到循环血液中所致。在IPHP后3 - 24小时，对照组热灌注后腹腔渗出液中的蛋白质浓度较高，因此，对照组热灌注后低蛋白血症较为明显。这些数据表明，对于接受IPHP治疗的胃癌患者，术前给予西咪替丁时，腹膜浆膜表面可免受烫伤，IPHP的副作用也会减少。
