4%甲醛溶液用于宫颈癌患者伴放射性直肠炎的临床体会

Clinical experience with 4% formaldehyde solution for cervical cancer patients with radiation proctitis

目的总结4%甲醛溶液用于治疗宫颈癌患者伴放射性直肠炎的临床体会。方法选取2015年3月1日至2016年1月1日来我院接受治疗的宫颈癌伴发放射性直肠炎的患者130例。随机将其分为甲醛治疗组和对症治疗组,每组各为65例患者。所有患者均接受同种治疗方案治疗宫颈癌。甲醛治疗组在放射性直肠炎病变区域,用浸有4%甲醛溶液的纱布覆盖5 min后取出,再用生理盐水冲洗肠道周围,每半月1次,共使用2月。对照治疗组则采取传统局部灌肠治疗放射性直肠炎的方法,1次/d,共1周。记录患者的下腹痛、肛门坠胀感等临床表现是否有好转,检测隐血试验,在结肠镜下观察直肠黏膜病变情况,并对治疗效果进行评估,并记录治疗过程中患者的不良反应情况。结果治疗后,甲醛治疗组痊愈占44.62%、显效43.08%、好转6.15%,总体有效率高达93.85%,高于对照治疗组的总体有效率,比较差异有统计学意义(P<0.05)。对比分析不良反应情况,甲醛治疗组发生肛周不适、肛周疼痛、阴道瘘及肛管深部溃疡各占15.38%、7.69%、3.08%及1.54%,总体发生率为27.69%,对照组患者的总体不良反应发生率为29.24%,二者比较差异无统计学意义(P>0.05)。结论对于宫颈癌伴发放射性直肠炎的患者,于基础控制宫颈癌发展的同时,使用4%甲醛溶液辅助治疗,可改善临床症状以及有效提高生活质量,且具有良好的安全性,可推荐广泛使用。

Objective To study clinical experience of 4% formaldehyde solution for cervical cancer patients with radiation proctitis. Methods We select 130 cervical cancer patients with radiation proctitis in our hospital from March 1, 2015 to January 1, 2016 as the survey. They were divided into Formaldehyde treatment group and symptomatic treatment group by the random number table method , 65 cases in each group. All patients received the same kind of treatment for cervical cancer. And formaldehyde treatment group found radiation proctitis lesion area in colonoscopy, with gauze soaked in 4% formaldehyde solution after 5min cover removed, then saline around the intestines, affecting the normal intestinal protection against formaldehyde, 2 time/mouth, for a total time of two months. Control treatment group was taken to the traditional method of treatment of radiation proctitis, dominal pain, heavy feeling in the anus and other clinical manifestations of improved detection of occult blood test in the colon rectal mucosa lesions were observed . Results The formaldehyde treatment group can be cured accounted for 44.62%, effective 43.08%, 6.15% improvement and overall efficiency as high as 93.85%, it was higher than the control group, the difference had statistically significance （P〈0.05）. In the incidence of adverse reactions, anal discomfort, pain, anal, vaginal fistula and anal deep ulcers each in formaldehyde treatment group were 15.38%, 7.69%, 3.08% and 1.54%, the overall rate was 27.69% in formaldehyde treatment group, while the control group was 29.24 %, there was no statistically significant （P〉0.05）. Conclusion In radiation proctitis patients associated with cervical cancer, using 4% formaldehyde solution on the basis of control for the development of cervical cancer , it can improve the clinical symptoms and improve the quality of life and have a good security, it should widespread use.