舒适护理对髓母细胞瘤患儿生存期影响的回顾性分析

Retrospective analysis of the effect of comfortable care on the survival time of children with medulloblastoma

目的探讨舒适护理联合手术治疗对髓母细胞瘤(MB)患儿生存期的影响。方法回顾性分析78例MB患者的临床资料,根据治疗方法的不同将患者分为手术组(n=38)和联合组(n=40),手术组患者采用单纯手术治疗,联合组患者采用舒适护理联合手术治疗。比较两组患者的临床疗效和生存情况。结果联合组患者的总有效率为50.0%(20/40),明显高于手术组患者的21.1%(8/38),差异有统计学意义(P﹤0.01)。联合组患者的临床疗效优于手术组患者,差异有统计学意义(P﹤0.05)。随访时间为1~12个月,中位随访时间为5个月。联合组患者的中位无进展生存期为7.2个月(95%CI:3.36~10.76),手术组患者的中位无进展生存期为4.5个月(95%CI:3.29~5.71)。联合组患者的中位无进展生存期长于手术组患者,差异有统计学意义(P﹤0.05)。联合组和手术组患者的1年总生存率分别为82.5%和68.4%,组间比较,差异无统计学意义(P﹥0.05)。结论 MB患者对舒适护理联合手术治疗的依从性较高,舒适护理联合手术治疗可提高MB患者的临床疗效,延长患者的无进展生存期,值得临床推广应用。

Objective To investigate the influence of comfort care combined with surgical treatment on the survival time of children with medulloblastoma（MB）. Method A retrospective analysis was performed on 78 patients with MB,these patients were included as surgery group（n=38） and combined therapy group（n=40） by respective treatment given,simple surgery was administered in surgery group, while comfortable care plus surgery combined with surgical treatment were given in combined therapy group. The clinical efficacy and survival of the two groups were compared. Result The overall response rate was 50.0%（20/40） in the combined therapy group, which was significantly higher than that in the surgery group at 21.1%（8/38）, and the difference was statistically significant（P0.01）. The clinical efficacy of the combined therapy group was better than that of the surgery group, demonstrating statistically significant difference（P0.05）.The follow-up time was 1 to 12 months, and the median follow-up time was 5 months. The median progression-free survival was 7.2 months in the combined therapy group, with 95% CI being 3.36-10.76, and that in the surgery group was4.5 months, the 95% CI was 3.29 to 5.71. Longer median progression-free survival was observed in the combined therapy group than in surgery group, and there was statistically significant difference observed（P0.05）. The 1-year overall survival rates of the combined therapy group and surgery group were 82.5% and 68.4%, respectively, though there was no significant difference noted between the two groups（P0.05）. Conclusion Comfortable care combined with surgical treatment of patients with medulloblastoma indicates high compliance, and may improve the clinical efficacy for medulloblastoma, and meanwhile could prolong the progression-free survival, and is clinically applicable.