分割短疗程放射治疗Ⅲb～Ⅳ期非小细胞肺癌的临床研究

目的:探讨分割短疗程放射治疗Ⅲb~Ⅳ期非小细胞肺癌(NSCLC)的效果及安全性。方法:选取2013年5月-2015年11月笔者所在医院收治的22例Ⅲb~Ⅳ期NSCLC患者作为研究对象,所有患者均接受分割短疗程放射治疗,观察治疗效果及安全性。结果:(1)22例患者中,21例患者完成计划照射剂量,1例患者由于1次放射治疗后出现痰液阻塞呼吸道继发严重窒息而中断治疗,治疗成功率为95.5%。(2)采用实体瘤疗效评价标准1.0版进行近期疗效评价,结果显示完全缓解(CR)3例,部分缓解(PR)15例,疾病稳定(SD)3例。所有患者均获得有效随访,其生存期为1~23个月,中位生存期为14个月。(3)不良反应发生情况:食管黏膜损伤致食管溃疡-食管-气管瘘2例(9.5%),放射性肺损伤10例(47.6%),气管肉芽组织增生12例(57.1%)。结论:分割短疗程放射治疗Ⅲb~Ⅳ期NSCLC的近期效果、远期效果均较好,但是应积极处理治疗过程中的不良反应。

短疗程小剂量抗凝治疗胎儿生长受限伴抗心磷脂抗体阳性的价值分析

目的:分析短疗程小剂量抗凝治疗胎儿生长受限伴抗心磷脂抗体阳性的价值。方法:2019年1月-2020年1月收治胎儿生长受限伴抗心磷脂抗体阳性孕妇70例,随机分为两组,各35例。对照组给予常规药物治疗;观察组在常规药物基础上增加短疗程小剂量抗凝。比较两组孕妇凝血功能、胎儿脐血流情况、头围和腹围水平。结果:观察组孕妇治疗后凝血功能活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)水平均显著高于对照组,D-二聚体、纤维蛋白原(FIB)水平显著均低于对照组,差异有统计学意义(P<0.05);观察组胎儿脐血流搏动指数(PI)和阻力指数(RI)水平均显著低于对照组,头围和腹围水平均显著高于对照组,差异有统计学意义(P<0.05)。结论:常规药物联合短疗程小剂量抗凝对于胎儿生长受限伴抗心磷脂抗体阳性的治疗效果确切,可有效改善孕妇凝血功能、胎儿脐血流情况及头围和腹围水平,改善胎儿生长受限。

莫西沙星治疗慢性支气管炎细菌感染急性发作的临床疗效观察

目的:观察莫西沙星短疗程治疗慢性支气管炎细菌感染急性发作(ABECB)的临床疗效。方法:将74例ABECB患者随机分为两组,治疗组用莫西沙星400mg,po.qd,治疗5d;对照组用克拉霉素500mg,po.bid,治疗5d。观察临床指标、细菌学、临床疗效及安全性。结果:治疗组与对照组的有效率分别为91.9%和78.4%,细菌清除率为89.2%和75.7%,两组比较差异有显著性(P<0.05)。结论:莫西沙星在短疗程下治疗慢性支气管炎急性细菌加重的疗效显著,是一种广谱、安全的抗菌药物。

Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment

AIM： To evaluate the utility of local tumor therapy combined with percutaneous transhepatic bilian/drainage （PTBD） for malignant obstructive bilian/disease. METHODS： A total of 233 patients with malignant billan/obstruction were treated in our hospital with PTBD by placement of metallic stents and/or plastic tubes. After PTBD, 49 patients accepted brachytherapy or extraradiation therapy or arterial infusion chemotherapy. The patients were followed up with clinical and radiographic evaluation. The survival and stent patency rate were calculated by Kaplan-Meier survival analysis. RESULTS： Twenty-two patients underwent chemotherapy （11 cases of hepatic carcinoma, 7 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy）, and 14 patients received radiotherapy （10 cases of cholangiocardnoma, 4 cases of pancreatic carcinoma）, and 13 patients accepted brachytherapy （7 cases of cholangiocarcinoma, 3 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy）. The survival rate of the local tumor treatment group at 1, 3, 6, and 12 months was 97.96%, 95.92%, 89.80%, and 32.59% respectively, longer than that of the non treatment group. The patency rate at 1, 3, 6, and 12 months was 97.96%, 93.86%, 80.93%, and 56.52% respectively. The difference of patency rate was not significant between treatment group and non treatment group. CONCLUSION： Our results suggest that local tumor therapy could prolong the survival time of patients with malignant biliary obstruction, and may improve stent patency.

Analysis of 80 Cases of Nasopharyngeal Carcinoma Treated by Intracavitary Brachytherapy Using A New-Type Applicator

OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma （NPC） treated with combined external-beam radiotherapy （EBR） and intracavitary brachytherapy （IB） using a new-type applicator. METHODS Eighty patients with untreated NPC were divided into two groups based on therapy methods. An experimental group was treated with EBR plus IB and a control group was treated only with EBR. IB was given to the patients of the experimental group when the external radiotherapy dose amounted to more than 60～65 Gy. The total dose of IB was 6～20 Gy and the total dose of EBR of the control group was 70～75 Gy. RESULTS Follow-up was conducted for 97.5% of the patients with re- suits as follows： the overall response rates （ORR） for the experimental and the control groups were 92.5% and 75.3% respectively （P〈0.05）; the 3 and 5-year survival rates for the experimental group were 87.5% and 74.2% and for the control group, 65.0% and 55.6% （P〈0.05）; for the experimental group, the 3 and 5-year disease-free survival rates were 72.5% and 64.5% and for the control group, 60.0% and 52.8% （P〉0.05）.Some complications following radiotherapy showed a significant difference. CONCLUSION External irradiation plus intracavitary brachytherapy using a new-type applicator may improve the ORR and survival rates, reduce radiation complications and increase the quality of life.

加替沙星治疗慢性支气管炎细菌感染急性发作的疗效观察

目的观察加替沙星短疗程治疗慢性支气管炎细菌感染急性发作（ABECB）的临床疗效。方法将74例ABECB住院患者采用随机盲法对照试验分为两组，治疗组用加替沙星胶囊200mg，口服，每天3次，治疗5d；对照组用环丙沙星片250mg，口服，每天3次，治疗5d。观察临床指标、细菌学、临床疗效及安全性。结果治疗组与对照组的有效率分别为91．9％和78．4％，细菌清除率为89．2％和75．7％，两组比较差异有统计学意义（P〈0．05）。结论加替沙星对急性细菌感染有很好的临床疗效和微生物学效果，耐受性和安全性好，不失为抗敏感菌感染可选药物，在短疗程内治疗慢性支气管炎急性细菌感染加重的疗效显著，是一种广谱、安全的抗菌药物。