三乙醇胺防治鼻咽癌放射性皮炎的临床观察

Clinical Observation of Trolamine Cream in the Prevention and Treatment of Acute Radioactive Dermatitis in Patients with Nasopharyngeal Carcinoma

目的:观察三乙醇胺乳膏(Trolamine Cream)在预防和治疗鼻咽癌患者急性放射性皮炎中的作用。方法:自2002年8月～2004年9月治疗125例鼻咽癌患者,其中37例在放疗开始时预防性用药作为预防组,51例在出现放射性皮炎时开始治疗性用药作为治疗组,37例采用常规处理作为对照组。结果:预防组出现放射性皮炎较慢,在照射DT20Gy时放射性皮炎发生率是29.7%(11例),而治疗组和对照组分别为70.6%(36例)和78.4%(29例),P<0.05;预防组和治疗组Ⅱ度放射性皮炎发生率分别为27%和59%,均未出现Ⅲ度以上放射性皮炎,而对照组Ⅱ度以上放射性皮炎达78%,其中Ⅲ度为5%,Ⅳ度为3%,P<0.05;预防组和治疗组放射性皮炎平均治愈时间也较对照组短,分别为5天、9天和13天。结论:三乙醇胺乳膏对急性放射性皮炎有较好的治疗效果,具有减轻皮肤放射性损伤和加速创面愈合的作用,为减轻患者痛苦、顺利完成放疗计划提供了良好保障。

Objective： To evaluate the efficacy of Trolamine cream in the prevention and treatment of acute radioactive dermatitis in patients with nasopharyngeal carcinoma. Methods： From 2002 to 2004, Trolamine cream was used in 125 cases with nasopharyngeal carcinoma, in combination with radiotherapy, for prevention and treatment of acute radiation dermatitis, among which 37 caseswere in the prevention group, 51 cases in the treatment group and 37 cases in the control group. Results： The results showed that in the prevention group, the rate of radioactive dermatitis at 20Gy was 29.7%（11/37）, that in the treatment group and the control group was 70.6%（36/51） and 78.4%（29/37）, respectively, P〈0.05. The rate of radiation dermatitis of grade II in the prevention and the treatment group was 27% and 59%, respectively, as compared to 78% in the control group （P〈0.05）. The mean time for curing radioactive dermatitis of grade II in the prevention, treatment and control group was 5, 9, and 13 days, respectively. Conclusion： Prophylactic application of Trolamine cream can postpone the development of radioactive dermatitis. Trolamine cream can lower acute radiation response in skin and hasten healing of acute radiation dermatitis.