^(90)Sr-^(90)Y敷贴治疗慢性湿疹的临床研究

^(90)Sr-^(90)Y Applicator Brachytherapy of Chronic Eczema Patients

目的系统地阐述90Sr-90Y敷贴器治疗局限性慢性湿疹的价值,验证照射剂量和照射方式与疗效的关系,以探索一种治疗局限性慢性湿疹的有效、科学和可行的方法。方法选择100名慢性湿疹患者为研究对象,按就诊顺序随机分为A,B,C,D共4组,行90Sr-90Y敷贴器治疗。A,B,D 3组分别接受大剂量(50Gy)、中等剂量(35Gy)、小剂量(15Gy)一次性照射,C组接受中等剂量(25~50Gy)每次7Gy隔日照射。照射后观察治疗后的变化,于治疗后6个月进行疗效评定,计算总有效率、治愈率和无效率等指标。结果各剂量组均取得了明显的疗效,治疗后6个月A,B,C 3组总有效率明显高于D组(χ2=10.27,3.94,12.5,P均<0.05)。C组治疗反应较温和,中到重度局部放射反应的发生明显低于A组和B组(χ2=8.4,4.5,P均<0.05)。结论使用90Sr-90Y敷贴治疗局限性慢性湿疹疗效确切,方法简便,成本低廉,中等剂量(25~50Gy)隔日照射组治疗反应温和,是敷贴治疗慢性湿疹的最佳方案,掌握得当可取得较好疗效。

Objective The aim of this study is to investigate the value of ^90Sr-^90Y applicator brachytherapy of chronic eczema patients and the relationship between brachytherapy dose and curative effect. Methods One hundred patients with eczema were divided into 4 groups named A, B, C and D, which were treated by ^90Sr-^90Y applicator. The patients in group A, B and D had accepted brachytherapy of 50Gy,35Gy and 15Gy once. Group C had accepted brachytherapy of 25Gy to 50Gy total dose by 7Gy alternate days. The curative effects were evaluated 6 months after brachytherapy. Total effective rate,curative rate and noneffective rate were calculated at the same time. Results Brachytherapy works in most of the patients. Group A, B and C had higher total effective rate than group D （x^2 = 10.27,3.94,12.5, P all 〈 0.05）. There were more patients with severe irradiation reaction in group A and B than in group C. Conclusion Brachytherapy of chronic eczema patients using ^90Sr-^90Y applicator can make authentic effect and satisfying cure rate. Brachytherapy with 7Gy alternate days which is 25Gy - 50Gy total can make perfect effect and high curative rate.