胰腺癌内照射腹泻探讨其止泻和胰酶剂之疗效  

Clinical study on the treatment of diarrhea with pancreatin entericcoated capsules following interstitial irradiation for pancreatic cancer

作　　者：杜苗苗[1] 曹贵文[2] 宁厚法[2] 余春林[1] 崔新江[2] 张志超[3] 张风庆 邢辉[2] 

机构地区：[1]潍坊医学院医学影像学系,山东潍坊261053 [2]潍坊医学院附属医院影像中心介入科,山东潍坊261031 [3]潍坊医学院临床医学院,山东潍坊261053

出　　处：《医学影像学杂志》2016年第8期1456-1459,共4页Journal of Medical Imaging

摘　　要：目的探讨蒙脱石散联合胰酶肠溶胶囊治疗胰腺癌^(125)I粒子植入术后顽固性腹泻的临床疗效。方法自2012年1月~2015年7月在我院行^(125)I粒子植入术后出现顽固性非炎症性腹泻的36例胰腺癌患者,将患者随机分为胰酶组和对照组两组,每组18例患者。对照组单纯采用蒙脱石散治疗,胰酶组采用蒙脱石散联合胰酶肠溶胶囊治疗,治疗2周后比较两组患者治疗效果。结果胰酶组症状评分从治疗前的平均2.89分降低至0.17分,对照组症状评分从治疗前平均3.0分降低至1.06分,治疗后两组间具有统计学差异(P<0.05)。胰酶组治疗有效17例,有效率94.44%;对照组治疗有效10例,有效率55.56%;组间差异显著(P<0.05)。胰酶组腹泻的停止时间及持续时间均优于对照组。药物不良反应胰酶组共发生4例,对照组共发生3例,两组药物不良反应的发生率均较低,无差异性(P>0.05),主要为恶心、皮疹及呕吐,患者均可耐受。结论蒙脱石散联合胰酶肠溶胶囊可显著改善胰腺癌125I粒子植入术后顽固性非炎症性腹泻,治疗效果确切,可明显改善患者临床症状,值得临床推广。Objective To explore the clinical efficacy of the treatment of intractable non-inflammatory diarrhea with montmo- rillonite and pancreatin entericcoated capsules following I25I brachytherapy for pancreas cancer. Methods 36 pancreas cancer patients who appeared intractable non-imqammatory diarrhea following 125I brachytherapy for pancreas cancer during the period of from January 2012 to July 2015 were randomly divided into pancreatin group and control group, with 18 cases in each group. Montmorillonite was given in control group, montmorillonite and pancreatin entericcoated capsules were given in paneratin group, the results of the treatment were compared after 2 weeks. Resnlts The average clinical scores had decreased from 2.89 to 1.07 in pancreatingroup, it had decreased from 3.0 to 1.06 in control group, there was significant difference between the two group （ P 〈0. 05） . There were 17 patients with effective treatment in pancreatin group, the effective rate was 94.44%. There were 10 patients with effective treatment in control group, the effective rate was 55.56%. There was significant difference between the two group （ P 〈 0.05 ）. The time of diarrhea stopped and durated was better in panereatin group than those in control group. There were 4 cases about adverse drug reactions in pancreatin group and 3 cases in control group. The rate of adverse effects was lower. There were no differences between the two groups （ P 〉 0.05）. The Main symptoms were nausea, rash and nausea and vomiting, which can be tolerated. Conclusion Combining montmorillonite powder with pancreatin enteric-coated capsules can significantly improve intractable non-inflammatory diarrhea following 125I brachytherapy for pancreatic carcinoma and has an exact effect on checking diarrhea. It can obviously improve the clinical symptoms of the patients and deserve the clinical expansion.

关 键 词：蒙脱石散 胰酶肠溶胶囊 胰腺癌 ^125I粒子植入术 顽固性非炎症性腹泻 

分 类 号：R736.7[医药卫生—肿瘤] R815[医药卫生—临床医学]