术前紫杉醇联合奈达铂化疗对局部晚期食管癌患者行食管切除术中出血量及术后根治性切除率的影响

Effects of preoperative paclitaxel combined with nedaplatin chemotherapy on the amount of bleed- ing and postoperative radical resection in patients with locally advanced esophageal carcinoma un- dergoing esophagectomy

目的 探讨术前紫杉醇联合奈达铂化疗对局部晚期食管癌患者行食管切除术中出血量及术后根治性切除率的影响。方法 选取62例局部晚期食管癌患者，随机数字表法分为对照组与研究组，每组31例。研究组采用紫杉醇联合奈达铂化疗（治疗2个周期）联合食管切除术，对照组仅采用食管切除术。统计对比两组手术情况、入院时及治疗后1个月生存质量评分、术后1个月并发症发生率，并于术后6～24个月进行随访，统计对比两组生存率。结果 研究组手术时间、住院时间与对照组比较，差异未见统计学意义（P〉0.05）；研究组术后出血量、根治性切除率高于对照组，差异有统计学意义（P〈0.05）。治疗前研究组社会功能、情绪功能、总体症状、躯体功能分值与对照组相比，差异未见统计学意义（P〉0.05）；治疗后1个月两组各维度分值较治疗前增高，且研究组高于对照组，差异有统计学意义（P〈0.05）。研究组并发症发生率[19.36%（6/31）]与对照组[25.82%（8/31）]比较，差异未见统计学意义（P〉0.05）。研究组治疗后6、12、18个月生存率与对照组比较，差异未见统计学意义（P〉0.05），研究组治疗后24个月生存率（77.42%）高于对照组（51.61%），差异有统计学意义（P〈0.05）。结论 食管切除术前联合采用紫杉醇及奈达铂进行化疗，可有效减少局部晚期食管癌患者术中出血量，提高根治性切除率、生存率，改善患者生存质量，且具有安全性。

Objective To investigate the effects of preoperative paclitaxel combined with nedaplatin chemotherapy on the amount of bleeding and postoperative radical resection in patients with locally advanced esophageal carcinoma undergoing esophagectomy.Methods Sixty-two patients with locally advanced esophageal cancer were randomly divided into control group and study group, with 31 cases in each group. The study group was given paclitaxel combined with nedaplatin chemotherapy and esophagectomy, and the control group was only given esophagectomy. At admission and 1 month after treatment, the incidence of complications were compared between the two groups. The patients were followed-up, life quality scores from 6 months to 24 months after operation, and the survival rates were compared.Results There was no significant difference in the surgical time or hospitalization time between the study group and the control group （P〉0.05）, but the postoperative bleeding volume and radical resection rate of the study group were significantly higher than those of the control group （P〈0.05）; Before treatment, there was no significant difference in the social function, emotional function, overall symptoms or physical function scores between the study group and the control group （P〉0.05）, but after 1 month of treatment, each score of the two groups was significantly higher than those before treatment, and those of the study group were significantly higher than those of the control group （P〈0.05）. There was no significant difference in the incidence of complications between the study group [19.36% （6/31）] and the control group [25.82% （8/31）] （P〉0.05）. There was no significant difference in the survival rate at 6 months, 12 months and 18 months after treatment between the study group and the control group （P〉0.05）, but the survival rate at 24 months after treatment of the study group [77.42% （24/31）] was higher than that of the control group [51.61% （16/31）], the difference was significant （P〈0.05）.Conclusions Paclitaxel combined with nedaplatin chemotherapy before esophagectomy can effectively reduce the intraoperative blood loss of patients with locally advanced esophageal cancer, and improve the radical resection rate, survival rate, improve the quality of life and has high safety.