蒙脱石散联合康复新液保留灌肠预防急性放射性直肠炎的临床观察

Clinical observation on the application of Montmorillonite with Kangfuxinye retention enema for prevention of acute radiation proctitis

目的探讨蒙脱石散联合康复新液保留灌肠预防急性放射性直肠炎的临床效果。方法将本院收治的109例盆腔放疗患者分为研究组（n=55）和对照组（n=54）,对照组予以常规准备,放疗前2 h排空大小便,饮温水500~800 ml,憋尿充盈膀胱,放疗期间鼓励高蛋白、高维生素饮食,忌食辛辣刺激性食物。研究组在对照组的基础上予以蒙脱石散3 g＋康复新液30 ml＋0.9%氯化钠溶液20 ml混合成灌肠液与放疗同步保留灌肠。比较两组患者急性放射性直肠炎的发生情况。结果研究组与对照组急性放射性直肠炎的发生率分别为18.2%和53.7%,其中1级分别为14.5%和31.5%,2级分别为3.6%和14.8%,3级分别为0和7.4%,差异均有统计学意义（P〈0.05）。结论蒙脱石散联合康复新液与放疗同步保留灌肠对预防盆腔放疗引起的急性放射性直肠炎有较好的预防作用,且操作方便,无明显毒副反应,患者易于接受。

Objective To investigate the clinical effects for prevention of acute radiation proctitis by using Montmorillonite with Kangfuxinye retention enema. Methods One hundred and nine patients who were treating with pelvic radiotherapy were divided into study group（ n = 55） and control group（ n = 54）. The control group received conventional preparation： empty bladder at two hours before radiotherapy,drink 500-800 ml warm water,hold urine until bladder fill,encourage patients to have high protein,high vitamin diet,and no spicy food during radiotherapy. The study group were given the same preparation as the control group and additionally taken enema which mixed by 30 ml Kangfuxinye,3 g Montmorillonite and 20 ml 0. 9% NS,as treating with radiotherapy and retention enema at the same time. The incidence of acute radiation proctitis between two groups were compared. Results The incidences of acute radiation proctitis in study group were 18. 2%,of which 14. 5% were grade 1,3. 6% were grade 2 and no grade 3 occured. On the other hand,the incidences of acute radiation proctitis in control group were 53. 7%,of which 31. 5% were grade 1,14. 8% were grade 2 and 7. 4% were grade 3. The differences between 2 groups were statistically significant（ P〈0. 05）. Conclusion Montmorillonite with Kangfuxinye retention enema combined with radiotherapy has better preventive effects for acute radiation proctitis which induced by pelvic radiation therapy. It has the advantages of convenient operation,no significant toxic and adverse effects,and high tolerance for patients.