热疗在放射性肺炎治疗过程中的临床疗效观察

Clinical efficacy of thermotherapy in the treatment of radiation pneumonitis

目的:观察深部热疗在放射性肺炎的治疗过程中对治疗效果的影响。方法:收集60例行胸部放射治疗后出现放射性肺炎的患者的病例资料,所有患者均为未行手术的肺癌患者。其为序贯或同步放化疗,放射治疗剂量为60~70 Gy(常规分割),预计生存期超过6月,放射治疗后均出现急性放射性肺炎患者,根据治疗是否行深部热疗随机分为两组,每组30例。对照组30例给予糖皮质激素与抗感染治疗,辅以吸氧、止咳、解痉平喘等对症处理;治疗组30例在对照组基础上加用深部热疗。热疗设备使用HG-2000体外局部高频热疗机,加温温度42℃~43℃,时间为40 min,隔日1次,共10次,分别检测放射性肺炎治疗前、放射性肺炎治疗后肺功能、血气分析的变化趋势。结果:治疗组放射性肺炎的总有效率、生存质量KPS评分、症状积分改善显著优于对照组(P<0.05);治疗后两组肺功能指标(VC、FEV1)、血气分析指标(PaO_2、PaCO_2)均有好转,且治疗组明显优于对照组(P<0.05);炎性因子hs-CRP、IL-6、TNF-α水平均明显下降,且治疗组好于对照组(P<0.05)。结论:深部热疗联合传统糖皮质激素治疗放射性肺炎,有助于放射性肺炎患者的症状、肺功能、血气分析、炎性指标的恢复,提高患者生活质量。

Objective：To observe the effect of deep thermotherapy in the treatment of radiation pneumonitis.Methods：60 cases of radioactive pneumonia patients were collected.All patients were with lung cancer and no surgery was performed,accepted the sequential or chemoradiation,radiotherapy dose for 60~70 Gy （regular）.Survival was expected to more than 6 months.Patients with acute radioactive pneumonia after radiotherapy,were randomly divided into two groups according to whether accepted deep thermal therapy,each group 30 cases.The control group was treated with glucocorticoid and anti-infective drugs,accompanied by oxygen,cough,ease tracheal spasm and smooth wheezing.The treatment group accepted deep thermal therapy on the basis of control group.Heat treatment equipment was the HG-2000 in vitro local high-frequency heat treatment machine,heating temperature of 42 ℃~43 ℃,time of 40 min,1 time every other day,total 10 times.Then pulmonary function and blood gas analysis were detected before and after treatment.Results：The total effective rate,KPS score and symptom score of radiation pneumonia in treatment group were significantly better than those in control group （P〈0.05）.Lung function index of two groups after treatment （VC and FEV1）,blood gas analysis index （PaO2,PaCO2） were improved,and the treatment group was improved better than that of control group （P〈0.05）.The levels of inflammatory factors （hs-CRP,IL-6 and TNF-α） were decreased significantly,and the treatment group was better than that of the control group （P〈0.05）.Conclusion：Deep hyperthermia combined with traditional glucocorticoid in the treatment of radiation pneumonitis can be beneficial to the symptoms,pulmonary function,blood gas analysis,inflammatory indexes and improve the quality of life in patients with radiation pneumonitis.