摘要
目的观察恶性肿瘤手术中分离切除肿瘤阶段手术用物上携带肿瘤脱落细胞的情况。方法择期恶性肿瘤切除手术60例,其中胃肠道肿瘤30例,肝脏肿瘤30例,选取手术器械、术者手套、擦血纱布为实验用物,将分离切除肿瘤时所使用的手术用物及时于载玻片上直接涂片,涂片经固定、晾干后送病理科做肿瘤细胞检测。结果肝脏肿瘤与胃肠道肿瘤携带肿瘤脱落细胞阳性率比较,差异有显著性意义(P<0.01);肝脏手术手套阳性率显著高于胃肠道(均P<0.05)。结论在恶性肿瘤的分离切除阶段手术用物确会被肿瘤脱落细胞污染,应高度重视手术用物的"减瘤或灭瘤"处理。
Objective The materials used in excision of malignant tumors were examined for exfoliated tumor cells during tumor separation. Methods Sixty elective operations for excision of malignant tumor were investigated, including 30 surgeries for removal of gastrointestinal tumors and 30 procedures for liver tumor excision. The materials examined including surgical instruments, gloves and gauze. The blood or tissues on the surface of the materials used for tumor separation were directly smeared onto slides. After fixation and drying, these slides were observed for tumor cells by pathologists. Results There was significant differences in the positive rate of tumor cells carried by the materials used for separation of tumor during operation between gastrointestinal operation and liver tumor operation （P〈0.01）. The positive rate of tumor cells carried by operative tools was significantly higher than those of gloves and gauze （P〈0.01 for both）. Conclusion Surgical materials used for the separation of malignant tumor during operation can be contamina ted by exfoliated tumor cells and measures should be taken to reduce or destroy tumor cells to prevent the implantation and metastases of tumor cells.
基金
南京医科大学第一附属医院科研项目(200409022)
