紫杉醇顺铂化疗方案联合内镜下黏膜剥离术治疗食管黏膜病变的临床研究  

Clinical study of paclitaxel cisplatin chemotherapy combined with endoscopic mucosal dissection on the treatment of esophageal mucosal lesions

作　　者：洪琛[1] 顾叶春 

机构地区：[1]浙江大学附属第二医院建德分院消化内科,杭州311600 [2]温州市中西医结合医院,浙江温州325008

出　　处：《中国临床药理学杂志》2016年第6期502-504,共3页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省医药卫生计划基金资助项目(2014KYB258)

摘　　要：目的观察紫杉醇顺铂化疗方案联合内镜下黏膜剥离术(ESD)治疗食管黏膜病变及胃肠动力学的影响情况。方法 80例食管黏膜病变的患者分为试验组和对照组,每组40例。试验组第1,8,15,22,29,36天静脉滴注紫杉醇400mg·m^(-2)+顺铂20 mg·m^(-2)化疗方案联合ESD,对照组单纯紫杉醇联合顺铂化疗方案。观察2组患者的近期疗效、远期疗效以及不良反应的情况,比较2组患者治疗后肠鸣音、胃肠蠕动、肛门排气、排便功能的恢复时间。结果试验组总有效率为80.00%(32/40),明显高于对照组的67.50%(27/40,P<0.05)。试验组肠鸣音、胃肠蠕动、肛门排气、排便功能的恢复时间为(53.14±3.18),(36.78±9.22),(43.12±10.44),(83.34±4.69)min,均短于对照组(75.21±3.77),(57.28±11.82),(63.82±10.28),(130.55±8.77)min(P<0.05)。试验组总生存率为70.00%(28/40),无进展生存率为60.00%(24/40),局部控制率为57.50%(23/40)均高于对照组的40.00%(16/40),25.00%(10/40),22.50%(9/40)(P<0.05)。2组不良反应发生率差异无统计学意义(P>0.05)。结论紫杉醇顺铂化疗联合ESD治疗食管黏膜病变比单纯的紫杉醇顺铂化疗疗效更好,胃肠动力恢复时间更短,近远期疗效更为显著。Objective To investigate the effect of paclitaxel and platinum chemotherapy combined with endoscopic mucosal dissection（ ESD）on esophageal mucosal lesions and its influence on the gastrointestinal dynamics. Methods A total of 80 cases of patients with esophageal mucosa lesions were divided into treatment group and control group,40 cases in each group. Treatment group was given paclitaxel 400 mg · m（-2）,cisplatin 20 mg·m（-2）chemotherapy combined with ESD at day 1,8,15,22,29,36. Control group was given paclitaxel combined with cisplatin chemotherapy. The short-term efficacy, long-term efficacy and adverse drug reactions,the recovery time of bowel sounds,gastrointestinal peristalsis,anal exhaust and defecation function after treatment were compared between two groups. Results After treatment, the total effective rate of the treatment group was 80. 00%（ 32 /40）,which was significantly higher than that of control group 67. 50%（ 27 /40）（ P〈0. 05）. The recovery time of bowel sound,gastrointestinal motility,anal exhaust and defecation in the treatment group were（ 53. 14 ± 3. 18）,（ 36. 78 ± 9. 22）,（ 43. 12 ± 10. 44）,（ 83. 34 ± 4. 69） min,which were shorter than those of control group（ 75. 21 ± 3. 77）,（ 57. 28 ± 11. 82）,（ 63. 82 ± 10. 28）,（ 130. 55 ± 8. 77） min（ P〈0. 05）. The total survival rate70. 00%（ 28 /40）,progression free survival（ 24 /40）,and local control rate 57. 50%（ 23 /40） in the treatment group were higher than 40. 00%（ 16 /40）,25. 00%（ 10 /40）,22. 50%（ 9 /40） in control group（ P〈0. 05）. Adverse drug reaction rates of the two groups had no significant difference（ P〈0. 05）. Conclusion For the patients with esophageal mucosal lesions the paclitaxel and cisplatin chemotherapy combined with ESD is better than the simple paclitaxel cisplatin chemotherapy,the recovery time of gastrointestinal motility is shorter,and the short and long-term effect is more obvious.

关 键 词：食管黏膜 胃肠动力 内镜下黏膜剥离术 

分 类 号：R979.1[医药卫生—药品]