高压氧联合黏膜保护剂治疗放射性肠炎的远期随访分析

The follow-up analysis of hyperbaric oxygen combined with mucosal protectant in the treatment of long-term radiation enteritis

目的探讨高压氧(HBO)联合黏膜保护剂治疗腹盆腔恶性肿瘤远期放射性肠炎(RE)的疗效及安全性。方法选取我院2010年1月—2016年12月收治的86例放射性肠炎患者,随机分为HBO治疗组和对照组,对照组接受黏膜保护剂治疗,HBO治疗组在对照组治疗的基础上联合HBO治疗,疗程均为4 w,对比分析两组患者的临床疗效、不良反应、营养状况和生活质量。结果 HBO治疗组的有效率(83.7%)显著高于对照组(55.8%),组间差异显著,存在统计学意义(P <0.05)。在HBO治疗过程中,出现头痛5例(11.6%),恶心呕吐7例(16.3%),耳鸣2例(4.6%)。随访终点时HBO治疗组平均BMI较放疗前无明显下降(t=1.17,P> 0.05)。两者总体生活质量(60.37±16.64)分vs.(51.75±14.30)分,预后良好者占83%vs. 55%。结论 HBO治疗远期放射性肠炎能够显著提高临床治疗效果,出现严重并发症的患者明显改善其生活质量和营养状态,且安全可行,具有较高的临床应用价值。

Objective To investigate the efficacy and safety of hyperbaric oxygen(HBO) combined with mucosal protective agents in the treatment of distant radiation enteritis(RE) in abdominopelvic malignancies. Methods Eighty-six patients with radiation enteritis admitted to our hospital from January 2010 to December 2016 were divided randomly into control group and HBO treatment group, both received mucosal protective agent treatment for 4 weeks and in the latter group, combined with HBO treatment. Comparative analysis of clinical efficacy, adverse effects, nutritional status and quality of life of the two groups of patients. Result The effective rate of HBO treatment group(83.7%) was significantly higher than that of the control group(55.8%), and the difference between the groups was statistically significant(P < 0.05). During HBO treatment, there were 5 cases of headache(11.6%), 7 cases of nausea and vomiting(16.3%), and 2 cases of tinnitus(4.6%). The average BMI of the HBO treatment group showed no significant decrease at the end of follow-up compared to pre-radiation(t=1.17, P > 0.05). The overall quality of life between HBO treatment group and control group was(60.37 ± 16.64)points and(51.75 ± 14.30) points respectively, with 83% and 55% of the group having a good prognosis respectively.Conclusion HBO treatment can significantly improve the clinical efficacy of long-term radiation enteritis along with the quality of life and nutritional status of patients with severe complications, which is of high clinical application value.