重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2013年
32期
3913-3915
,共3页
黄疸 ,阻塞性%三维适形放射治疗%恶性肿瘤%临床疗效
黃疸 ,阻塞性%三維適形放射治療%噁性腫瘤%臨床療效
황달 ,조새성%삼유괄형방사치료%악성종류%림상료효
jaundice,obstructive%three-dimensional conformal radiation therapy,malignant tumor%clinical efficacy
目的：探讨辅助三维适形放疗对恶性肿瘤所致阻塞性黄疸的影响及临床疗效。方法选取肝、胆、胰腺恶性肿瘤所致的阻塞性黄疸患者90例，分为观察组与对照组，每组45例。对照组给予相应的综合治疗措施，括手术切除肿瘤，术后化疗和术后立体放疗。观察组在手术切除肿瘤，术后化疗的基础上，给予术后三维适形放疗。治疗后2个月观察两组的临床疗效、血清胆红素水平，记录期间不良反应、随访2年的生存率。结果观察组总有效率75．56％、不良反应发生率（37．78％）与对照组（57．78％）比较，差异有统计学意义（ P＜0．05）。治疗后，两组患者血清总胆红素、直接胆红素均较治疗前降低（ P＜0．01）；观察组血清总胆红素[（26．3±6．5）μmol/L]、直接胆红素[（18．9±3．3）μmol/L]与对照组[（39．3±9．5）、（26．9±6．7）μmol/L]比较，差异有统计学意义（P＜0．05）。观察组患者生存率高于对照组（P＜0．05）。结论辅助三维适形放疗对恶性肿瘤所致的阻塞性黄疸具有较好的临床疗效，可延长患者生存时长、降低血清胆红素含量、改善黄疸症状等，对其治疗具有一定的指导意义。
目的：探討輔助三維適形放療對噁性腫瘤所緻阻塞性黃疸的影響及臨床療效。方法選取肝、膽、胰腺噁性腫瘤所緻的阻塞性黃疸患者90例，分為觀察組與對照組，每組45例。對照組給予相應的綜閤治療措施，括手術切除腫瘤，術後化療和術後立體放療。觀察組在手術切除腫瘤，術後化療的基礎上，給予術後三維適形放療。治療後2箇月觀察兩組的臨床療效、血清膽紅素水平，記錄期間不良反應、隨訪2年的生存率。結果觀察組總有效率75．56％、不良反應髮生率（37．78％）與對照組（57．78％）比較，差異有統計學意義（ P＜0．05）。治療後，兩組患者血清總膽紅素、直接膽紅素均較治療前降低（ P＜0．01）；觀察組血清總膽紅素[（26．3±6．5）μmol/L]、直接膽紅素[（18．9±3．3）μmol/L]與對照組[（39．3±9．5）、（26．9±6．7）μmol/L]比較，差異有統計學意義（P＜0．05）。觀察組患者生存率高于對照組（P＜0．05）。結論輔助三維適形放療對噁性腫瘤所緻的阻塞性黃疸具有較好的臨床療效，可延長患者生存時長、降低血清膽紅素含量、改善黃疸癥狀等，對其治療具有一定的指導意義。
목적：탐토보조삼유괄형방료대악성종류소치조새성황달적영향급림상료효。방법선취간、담、이선악성종류소치적조새성황달환자90례，분위관찰조여대조조，매조45례。대조조급여상응적종합치료조시，괄수술절제종류，술후화료화술후입체방료。관찰조재수술절제종류，술후화료적기출상，급여술후삼유괄형방료。치료후2개월관찰량조적림상료효、혈청담홍소수평，기록기간불량반응、수방2년적생존솔。결과관찰조총유효솔75．56％、불량반응발생솔（37．78％）여대조조（57．78％）비교，차이유통계학의의（ P＜0．05）。치료후，량조환자혈청총담홍소、직접담홍소균교치료전강저（ P＜0．01）；관찰조혈청총담홍소[（26．3±6．5）μmol/L]、직접담홍소[（18．9±3．3）μmol/L]여대조조[（39．3±9．5）、（26．9±6．7）μmol/L]비교，차이유통계학의의（P＜0．05）。관찰조환자생존솔고우대조조（P＜0．05）。결론보조삼유괄형방료대악성종류소치적조새성황달구유교호적림상료효，가연장환자생존시장、강저혈청담홍소함량、개선황달증상등，대기치료구유일정적지도의의。
Objective To investigate the influence and clinical effect of assisted three-dimensional conformal radiation therapy (3D-CRT ) on obstructive jaundice caused by malignant tumors .Methods 90 cases with obstructive jaundice caused by malignant tumors of liver ,gallbladder and pancreases were randomly divided into observation group and control group ,45 cases in each group . Patients in control group were given comprehensive measures ,including tumors exairesis ,assisted chemotherapy and stereotactic ra-diotherapy ,and patients in observation group were given 3D-CRT based on tumors exairesis and assisted chemotherapy .Clinical effect ,serum bilirubin were observed 2 months after treatment ,adverse reactions were recorded during the treatment ,and survival rate in 2-year follow up in two groups were observed .Results Total effective rate in observation group and control group were 75 .56% and 57 .78% (P<0 .05) ,respectively ,and adverse reactions rate were 37 .78% and 57 .78% (P<0 .05) ,respectively .After treatment ,serum total bilirubin and direct bilirubin in two groups were all lower than those before treatment (P<0 .05) .Serum total bilirubin and direct bilirubin in observation group after treatment were (26 .3 ± 6 .5)μmol/L and(18 .9 ± 3 .3)μmol/L ,and were (39 .3 ± 9 .5)μmol/L and(26 .9 ± 6 .7)μmol/L in control group ,and there were statistical difference between two groups (P<0 .05) . Observation group′s survival rate was higher than that of control group (P<0 .05) .Conclusion It has good clinical effect of trea-ting obstructive jaundice caused by malignant tumors by 3D-CRT ,and it prolongs the survival time ,decreases serum bilirubin and improves jaundice symptom ,so it has some guiding significance to its treatment .
