CAJ | 학술논문

目的观察老年肺癌患者行放射性粒子植入术后分别应用大剂量与小剂量沐舒坦治疗的肺保护效果. 方法选取2012年3月至2013年3月在天津医科大学第二医院胸外科行CT引导下肺癌放射性粒子植入治疗的93例非小细胞肺癌患者,随机分成大剂量组、小剂量组以及对照组,每组31例,三组患者在术后行常规免疫以及营养支持等综合治疗的基础上大剂量组给予沐舒坦990mg/d持续静脉泵入,小剂量组给予300 mg/d持续静脉泵入,对照组给生理盐水,比较三组患者术中气胸发生率和术后第1、3、5天的C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、中性粒细胞绝对值(ANC)的水平差异. 结果三组患者CRP、TNF-α以及ANC水平在术后第1、3天差异无统计学意义(P＞0.05),大剂量组患者CRP、TNF-α以及ANC在术后第5天均低于小剂量组和对照组(F=3.596、3.555、3.406,P=0.031、0.033、0.037),大剂量组气胸发生率低于对照组(x2=4.31,P＜0.05). 结论老年肺癌放射性粒子植入术围术期应用大剂量沐舒坦治疗有助于较快减轻肺部的炎性反应,减少气胸发生率.
목적 관찰노년폐암환자행방사성입자식입술후분별응용대제량여소제량목서탄치료적폐보호효과. 방법 선취2012년3월지2013년3월재천진의과대학제이의원흉외과행CT인도하폐암방사성입자식입치료적93례비소세포폐암환자,수궤분성대제량조、소제량조이급대조조,매조31례,삼조환자재술후행상규면역이급영양지지등종합치료적기출상대제량조급여목서탄990mg/d지속정맥빙입,소제량조급여300 mg/d지속정맥빙입,대조조급생리염수,비교삼조환자술중기흉발생솔화술후제1、3、5천적C반응단백(CRP)、종류배사인자α(TNF-α)、중성립세포절대치(ANC)적수평차이. 결과 삼조환자CRP、TNF-α이급ANC수평재술후제1、3천차이무통계학의의(P＞0.05),대제량조환자CRP、TNF-α이급ANC재술후제5천균저우소제량조화대조조(F=3.596、3.555、3.406,P=0.031、0.033、0.037),대제량조기흉발생솔저우대조조(x2=4.31,P＜0.05). 결론 노년폐암방사성입자식입술위술기응용대제량목서탄치료유조우교쾌감경폐부적염성반응,감소기흉발생솔.
Objective To observe the pulmonary protective effect of large and small doses of mucosolvan in elderly patients with lung cancer undergoing radioactive seed implantation.Methods 93 patients with non-small cell lung cancer undergoing radioactive seed implantation guided by CT were selected and randomly divided into 3 groups:the high-dose group,the low-dose group and control group (n-31,each).All patients received the mucosolvan treatment with routine immunization and nutrition support after implantation.Patients was given mucosolvan 990 mg/d and 300 mg/d by continuous intravenous pumping in high-dose and small-dose groups respectively.Patients in the control group was given saline.The incidence of pneumothorax and plasma levels of C reactive protein (CRP),tumor necrosis factor alpha (TNF alpha),neutrophils (ANC) were compared between the three groups at 1 d,3 d and 5 d after implantation.Results There was no statistically significant difference in plasm levels of CRP,TNF alpha and ANC between the three groups at 1 d and 3 d after implantation (all P＞0.05).Plasma levels of CRP,TNF alpha and ANC were lower in highdose group than in low-dose group and control group at 5 d after implantation (F=3.596,3.555,3.406,respectively,all P＜0.05).The incidence of pneumothorax was lower in high dose group than in control group (x2 =4.31,P ＜ 0.05).Conclusions Perioperative application of high-dose mucosolvan can relieve lung inflammatory reaction rapidly and reduce the incidence of pneumothorax in elderly lung cancer patients undergoing radioactive seed implantation.