辅助三维适形放疗对恶性肿瘤所致阻塞性黄疸的影响及疗效分析  

Influence and clinical effect analysis of assisted three-dimensional conformal radiation therapy on obstructive jaundice caused by malignant tumors

作　　者：张晓华[1] 张战民[1] 

机构地区：[1]南昌大学第一附属医院肿瘤科,南昌330006

出　　处：《重庆医学》2013年第32期3913-3915,共3页Chongqing medicine

摘　　要：目的探讨辅助三维适形放疗对恶性肿瘤所致阻塞性黄疸的影响及临床疗效。方法选取肝、胆、胰腺恶性肿瘤所致的阻塞性黄疸患者90例,分为观察组与对照组,每组45例。对照组给予相应的综合治疗措施,括手术切除肿瘤,术后化疗和术后立体放疗。观察组在手术切除肿瘤,术后化疗的基础上,给予术后三维适形放疗。治疗后2个月观察两组的临床疗效、血清胆红素水平,记录期间不良反应、随访2年的生存率。结果观察组总有效率75.56%、不良反应发生率(37.78%)与对照组(57.78%)比较,差异有统计学意义(P<0.05)。治疗后,两组患者血清总胆红素、直接胆红素均较治疗前降低(P<0.01);观察组血清总胆红素[(26.3±6.5)μmol/L]、直接胆红素[(18.9±3.3)μmol/L]与对照组[(39.3±9.5)、(26.9±6.7)μmol/L]比较,差异有统计学意义(P<0.05)。观察组患者生存率高于对照组(P<0.05)。结论辅助三维适形放疗对恶性肿瘤所致的阻塞性黄疸具有较好的临床疗效,可延长患者生存时长、降低血清胆红素含量、改善黄疸症状等,对其治疗具有一定的指导意义。Objective To investigate the influence and clinical effect of assisted three-dimensional conformal radiation therapy （3D-CRT） on obstructive jaundice caused by malignant tumors. Methods 90 cases with obstructive jaundice caused by malignant tumors of liver,gallbladder and pancreases were randomly divided into observation group and control group, 45 cases in each group. Patients in control group were given comprehensive measures,including tumors exairesis, assisted chemotherapy and stereotactic ra- diotherapy,and patients in observation group were given 3D-CRT based on tumors exairesis and assisted chemotherapy. Clinical effect,serum bilirubin were observed 2 months after treatment, adverse reactions were recorded during the treatment, and survival rate in 2-year follow up in two groups were observed. Results Total effective rate in observation group and control group were 75.56% and 57.78 % （P〈0. 05）, respectively, and adverse reactions rate were 37.78 % and 57.78 % （P〈0.05）, respectively. After treatment, serum total bilirubin and direct bilirubin in two groups were all lower than those before treatment（P〈0.05）. Serum total bilirubin and direct bilirubin in observation group after treatment were（26. 3 ± 6. 5）μmol/L and（18. 9 ± 3. 3）μmol/L, and were （39.3± 9.5）μmol/L and（26.9 ± 6.7）btmol/L in control group, and there were statistical difference between two groups（P〈0.05）. Observation group＇s survival rate was higher than that of control group（P〈0.05）. Conclusion It has good clinical effect of trea- ting obstructive jaundice caused by malignant tumors by 3D-CRT, and it prolongs the survival time, decreases serum bilirubin and improves jaundice symptom,so it has some guiding significance to its treatment.

关 键 词：黄疸 阻塞性 三维适形放射治疗 恶性肿瘤 临床疗效 

分 类 号：R730.55[医药卫生—肿瘤]