术前用惠若舒治疗食管癌患者化疗后白细胞减少症及手术的临床随机对比研究

A randomized controlled and clinical study of Hemarisin on leukopenia induced by chemotherapy in preoperative patients with esophageal carcinoma

目的 观察惠若舒对化疗后有白细胞减少但仍有手术指征的食管癌患者实施手术治疗及术后并发症影响。方法 将 3 7例化疗后食管癌患者 (外周血WBC <4.0× 10 9/L)随机地分为A、B两组 :A组 (惠若舒组 ,共 10例 )患者化疗后 1周立即给予惠若舒肌注 ( 5 0 μg/d× 14d) ,B组 (鲨肝醇组 ,共 2 7例 )患者则立即给予鲨肝醇口服 ( 0 .1tid× 14d) ,每隔 3天查 1次患者外周血WBC ;14d后A、B两组患者均接受手术治疗 (均为左6肋间开胸 ,食管癌切除加胃—食管左胸顶器械吻合术 ) ,并观察A、B两组患者吻合口瘘、脓胸和切口感染等并发症的发生率及术后平均住院日。结果 A、B两组患者在用药后外周血WBC平均升高数 (A :( 3 .2± 0 .2 )× 10 9/L ,B :( 1.5± 0 .1)× 10 9/L ;P <0 .0 1)、外周血白细胞上升至 4.0× 10 9/L所需要的时间 (A :7± 1.1d ,B :14± 2 .3d ;P <0 .0 1)及平均住院日 (A :7± 1.5d ,B :11± 2 .8d ;P=0 .0 0 0 1) ,差异有显著性 ,而术后总并发症 (含 :吻合口瘘、脓胸及切口感染等 )发生率 (A :0 .0 0 %,B :14 .81%;P =0 .5 5 71)和治愈率 (A :10 0 .0 %,B :92 .6;P =0 .99)方面差异均无显著性 (可能均与样本数较少有关 )。结论 一部分化疗后白细胞减少而又能接受手术切除的患者 ,使用惠若舒治?

Objective To allow some patients of esophageal carcinoma with leukopenia caused by chemotherapy to operate early.Methods Thirty-seven enrolled postchemotherapeutic patients of esophageal carcinoma with leukopenia caused by chemotherapy (WBC<4.0×10 9/L) were randomized into group A(Hemarisin, 10 cases) and B (batyl alcohol, 27 cases). In group A, Hemarisin was given 50 μg/day (×14 days) IM, while in group B, batyl alhcool was also used 0.3/day (0.1 tid ×14 days) orally. All patients' WBC had been tested every three days. They had all received thoracic operation treatment in two weeks of postmedicated (Intercostal space of Left 6, the resection of esophageal carcinoma and esophagogastroauastomosis on left upper thoracic part). The postoperative days of hospitalization and the operative complications (anaslomolic leakage,pyothorax and infection of incisional wound) were be observed.Results There were statistical significances between group A and B in rising WBC mean numbers (A:(3.2±0.2)×10 9/L,B:(1.5±0.1)×10 9/L; P <0.01), the necessary time of WBC would be risen up to 4.0×10 9/L before operation (A:7±1.1 d, B:14±2.3 d; P <0.01) and hospitalization in mean days (A:7±1.5 d,B:11±2.8 d, P =0.0001).There were no statistical significances between group A and B in the total incidence rate of complications (for example:anastomotic leakage,pyothorax, infection of incisional wound, and so on.) (A:0.00%,B:14.81%, P =0.5571) and the cure rate (A:100.0%,B:92.6%; P =0.99). These would be asssociated with a fewer samples in this study.Conclusion Patients who received chemotherapy and had leukopenia, Hemarisin not only would shorten patients' time of preoperation and hospitalization days, but also reduce the incidence of complications.