CAJ | 학술논문

目的探讨甲基强的松龙、鼠神经生长因子以及高压氧治疗鼻咽癌患者放射治疗后出现的放射性后组颅神经损伤的疗效.方法将鼻咽癌放射治疗后有放射性后组颅神经损伤的50例患者按照随机数字表法分为2组.治疗组25例给予甲基强的松龙60-80mg静脉滴注.持续10 d后逐渐减量;给予鼠神经生长因子(金路捷)20ìg肌肉注射,每天1次,连用28 d;高压氧治疗10次;乙酰谷酰胺500mg静脉滴注,每天1次,连用28d.对照组25例给予维乐生2片,每天3次,连用45 d;复方丹参片3片,每天3次.连用45 d.结果治疗组总有效率96%,对照组总有效率12%,治疗组优于对照组,差异有统计学意义(P<0.05).治疗组中未行化疗以及损伤症状持续时间越短者疗效好,与行化疗和持续时间越长者比较,差异有统计学意义(P<0.05).结论甲基强的松龙、鼠神经牛长因子以及高压氧治疗等联合应用能较有效地改善鼻咽癌放射性后组颅神经损伤的症状,其疗效与症状持续时间的长短以及有无配合化疗有关,对早期损伤者建议积极治疗.
목적 탐토갑기강적송룡、서신경생장인자이급고압양치료비인암환자방사치료후출현적방사성후조로신경손상적료효.방법 장비인암방사치료후유방사성후조로신경손상적50례환자안조수궤수자표법분위2조.치료조25례급여갑기강적송룡60-80mg정맥적주.지속10 d후축점감량;급여서신경생장인자(금로첩)20ìg기육주사,매천1차,련용28 d;고압양치료10차;을선곡선알500mg정맥적주,매천1차,련용28d.대조조25례급여유악생2편,매천3차,련용45 d;복방단삼편3편,매천3차.련용45 d.결과 치료조총유효솔96%,대조조총유효솔12%,치료조우우대조조,차이유통계학의의(P<0.05).치료조중미행화료이급손상증상지속시간월단자료효호,여행화료화지속시간월장자비교,차이유통계학의의(P<0.05).결론 갑기강적송룡、서신경우장인자이급고압양치료등연합응용능교유효지개선비인암방사성후조로신경손상적증상,기료효여증상지속시간적장단이급유무배합화료유관,대조기손상자건의적겁치료.
Objective To evaluate the therapeutic effect of comprehensive treatments for radiation-induced lower cranial neuropathy in patients with nasopharyngeal carcinoma (NPC). Meathods Fifty NPC patients with radiation-induced lower cranial neuropathy were randomly divided into comprehensive treatment group and control group. In the former group, the 25 patients received 10 sessions of hyperbaric oxygen treatment in addition to intravenous infusion of methyprednisolone (60-80 mg, once daily for 10 consecutive days) and aceglutamide (500 mg, once daily for 28 days), with also patients in the control group were given 2 compound vitamine B tablets and 3 compound Denshen tablets three times a day for 45 days. Results The excellent effect, improvement, non-response, and exacerbation rates in the comprehensive treatment group were 24%, 72%, 4%, and 0%, as compared to the rates of 0%, 12%, 80%, and 8% in the control group, respectively. The overall response rate in the comprehensive treatment group was 96%, significantly higher than that in the control group (12%, P<0.05). In the patients receiving comprehensive treatment, exclusion of chemotherapy and shorter duration of symptoms of nerve damage were associated with better therapeutic effect (P<0.05). Conclusion Methyprednisolone, mouse nerve growth factor and hyperbaric oxygen treatment can relieve the symptoms of radiation-induced lower cranial neuropathy in NPC patients, and the therapeutic effect of the treatments is associated with chemotherapy and sustaining time of the symptoms of nerve damage, suggesting the necessity of early treatment of neurological impairment in these patinets.