黏膜保护剂保留灌肠预防宫颈癌放疗所致急性肠炎的原因分析

Causes of retention enema with mucosal protective agent to prevent the acute radiation enteritis on the cervical cancer patients with radiation therapy

目的:探讨宫颈癌放射治疗期间使用思密达、地塞米松混合液保留灌肠减轻急性放射性肠炎的发生及原因。方法:90例行根治性放疗的宫颈癌患者随机分为黏膜保护剂保留灌肠组和未灌肠组,治疗组在放疗前1 h予50 ml生理盐水,3 g思密达和5 mg地塞米松保留灌肠,比较两组放射性直肠炎程度并分析原因。结果:90例宫颈癌根治性放疗患者中,观察组放射治疗后期(第4,5周)Ⅱ度以上放射性肠炎的发生率明显低于对照组(P<0.01)。结论:随着放射剂量的增加急性放射性肠炎的症状加重;放射治疗前使用黏膜保护剂保留灌肠可能一定程度上减少了直肠和乙状结肠黏膜上皮细胞对放射线的敏感性,使直肠和乙状结肠黏膜上皮细胞的损伤减轻。

Objective： To investigate the reasons of retention enema with smecta and dexamethasone to reduce the acute radiation enteritis on cervical cancer patiens with radiation therapy. Methods： 90 cervical cancer patients with the radical radiation therapy were randomized into retention enema group treated with mucosal protective agent and the untreated group. In the treatment group,50 ml saline with 3 g smecta and5 mg dexamethasone were given for retention enema 1h before radiationtherapy. The degree of radiation proctitis of both groups was compared and its causes was analyzed. Results： Of the 90 patients underwent radical radiation therapy,incidence of radiation enteritis of level 2 and above in the advanced stage（ after the 4thor 5thweeks of radiationtherapy） were significantly lower than that of the untreated group（ P〈0.01）.Conclusion： With the increase of doses of radiation,the symptoms of acute radiation enteritis aggravated;the treatment of retention enema with mucosal protective agent before the radiationtherapy on the cervical cancer patients may reduce the radiation sensitivity of the intestine epithelial cell and decrease the damage of rectum and sigmoid mucosal epithelial cells.