CAJ | 학술논문

目的探讨同步高压氧治疗对脑胶质瘤术后联合放化疗患者疗效及生存能力与质量的影响. 方法选择广州军区广州总医院神经外科及解放军第四五七医院神经外科自2009年1月至2013年12月收治的脑恶性胶质瘤术后患者86例,根据患者及其家属意愿分为2组,高压氧组47例术后行高压氧联合放化疗治疗,对照组39例术后单纯行放化疗.化疗方案:术后2～4周(平均3周)开始化疗,第1周期口服替莫唑胺150 mg/m2体表面积,1次/d,连续服用5d;第2～5周期口服替莫唑胺200 mg/m2体表面积,1次/d,连续服用5d,均完成5周期化疗.高压氧治疗方案:与口服替莫唑胺的周期同步,高压氧治疗时长60 min,压力为2.8个大气压,高压氧治疗后30 min内口服替莫唑胺.2组病例化疗后均常规行放疗,6000 cGy/30F.采用WHO制定的实体肿瘤化疗敏感性评判标准评估并比较2组患者治疗有效率,采用日常生活能力评分(ADL)量表及SF-36量表评估患者治疗前及治疗后3个月、6个月的生存能力及生存质量. 结果高压氧组总有效率、治疗后3个月及6个月的ADL＞60分比例分别为95.74％、53.2％、72.3％,明显高于对照组上述3项指标(分别为58.97％、30.8％、48.7％),差异有统计学意义(P＜0.05).高压氧组术后3个月、术后6个月SF-36量表各指标评分亦明显高于对照组相应指标,差异有统计学意义(P＜0.05). 结论术后同步高压氧治疗可提高放化疗对脑胶质瘤的疗效,改善患者预后.
목적 탐토동보고압양치료대뇌효질류술후연합방화료환자료효급생존능력여질량적영향. 방법 선택엄주군구엄주총의원신경외과급해방군제사오칠의원신경외과자2009년1월지2013년12월수치적뇌악성효질류술후환자86례,근거환자급기가속의원분위2조,고압양조47례술후행고압양연합방화료치료,대조조39례술후단순행방화료.화료방안:술후2～4주(평균3주)개시화료,제1주기구복체막서알150 mg/m2체표면적,1차/d,련속복용5d;제2～5주기구복체막서알200 mg/m2체표면적,1차/d,련속복용5d,균완성5주기화료.고압양치료방안:여구복체막서알적주기동보,고압양치료시장60 min,압력위2.8개대기압,고압양치료후30 min내구복체막서알.2조병례화료후균상규행방료,6000 cGy/30F.채용WHO제정적실체종류화료민감성평판표준평고병비교2조환자치료유효솔,채용일상생활능력평분(ADL)량표급SF-36량표평고환자치료전급치료후3개월、6개월적생존능력급생존질량. 결과 고압양조총유효솔、치료후3개월급6개월적ADL＞60분비례분별위95.74％、53.2％、72.3％,명현고우대조조상술3항지표(분별위58.97％、30.8％、48.7％),차이유통계학의의(P＜0.05).고압양조술후3개월、술후6개월SF-36량표각지표평분역명현고우대조조상응지표,차이유통계학의의(P＜0.05). 결론 술후동보고압양치료가제고방화료대뇌효질류적료효,개선환자예후.
Objective To explore the influence of chemoradiotherapy combined with inhalation of hyperbaric oxygen in short-term therapeutic effectiveness,viability and quality of life of postoperative patients with malignant gliomas.Methods A total of 86 patients with malignant gliomas,admitted to our hospital from January 2009 to December 2013,were chosen in our study; according to the wishes of patients and their families,all patients were divided into two groups:chemoradiotherapy combined with inhalation of hyperbaric oxygen group (n=47) and chemoradiotherapy group (n=39).Chemotherapy regimens were given:temozolomide of 150 mg/m2 body surface area at the first period once daily for a consecutive five days and temozolomide of 200 mg/m2 body surface area since the second period once daily for consecutive five days.Hyperbaric oxygen therapy was given with duration of 60 min at pressure of 2.8 atm.Conventional radiotherapy (6000 cGy/30F) was given in both groups.WHO established solid tumor chemosensitivity criteria was used to evaluate the effective rate of total symptoms,and activity of daily living (ADL) scale and F-36 scale were employed to evaluate the viability and life quality before and three and six months after the intervention.Results The effective rate of total symptoms,ratio of ADL＞60 points in chemoradiotherapy combined with inhalation of hyperbaric oxygen group 3 and 6 months after treatment were 95.74 ％,53.2％ and 72.3％,which were significantly higher than those in the chemoradiotherapy group (58.97 ％,30.8％ and 48.7％,P＜0.05).The scores of all the items of SF-36 scale in chemoradiotherapy combined with inhalation of hyperbaric oxygen group 3 and 6 months after treatment were significantly higher than those in the chemoradiotherapy group (P＜0.05).Conclusion Inhalation of hyperbaric oxygen can significantly improve short-term therapeutic effectiveness,survival duration,viability and quality of life of postoperative patients with malignant gliomas,and obviously improve the prognosis of patients.