应用糜蛋白酶治疗鼻咽癌放疗后鼻咽部结痂的疗效  

Efficacy of Chymotrypsin in Treatment of Nasopharyngeal Scab After Radiotherapy for Nasopharyngeal Carcinoma

作　　者：杨文飞[1] 郑芸[1] 王英斌[1] 金日群[1] 曾琳[1] 彭韶平[1] YANG Wenfei;ZHENG Yun;WANG Yingbin(First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院,江西赣州341000

出　　处：《中国医学创新》2018年第1期45-49,共5页Medical Innovation of China

摘　　要：目的:观察应用糜蛋白酶溶液浸泡鼻咽部加鼻腔0.9%氯化钠溶液冲洗对鼻咽癌放射治疗后鼻咽部结痂及黏膜炎症反应的治疗效果。方法:选取2016年5月-2017年8月本院因鼻咽癌根治性放疗后鼻咽部重度结痂的患者64例,将其分为试验组和对照组,每组各32例。试验组采用400 U/m L浓度糜蛋白酶溶液10 m L经滴鼻浸泡鼻咽部20 min,然后再用0.9%氯化钠溶液行鼻腔冲洗;对照组采用0.9%氯化钠溶液10 m L经滴鼻浸泡鼻咽部20 min,然后再用0.9%氯化钠溶液行鼻腔冲洗,两组治疗频率均为2次/d。治疗2周后在电子鼻咽喉镜下观察鼻咽部结痂及黏膜炎症反应治疗效果。结果:试验组鼻咽部黏膜炎症反应治疗有效率为62.5%,高于对照组的25.0%(P<0.05);试验组鼻咽部结痂清除治疗有效率为78.1%,高于对照组的31.3%(P<0.05)。结论:鼻咽癌放疗后鼻咽结痂严重者采用经鼻滴入糜蛋白酶溶液浸泡鼻咽部后再0.9%氯化钠溶液冲洗,能增强对鼻咽癌放疗后鼻咽黏膜炎症的恢复,增强鼻咽部结痂冲洗的治疗效果。Objective:To observe the therapeutic effect of nasopharynx immersion with chymotrypsin solution and normal saline washing in nasal cavity on nasopharyngeal scab and mucosal inflammation after radiotherapy for nasopharyngeal carcinoma.Method:A total of 64 patients with severe scab of nasopharynx after radical radiotherapy of nasopharyngeal carcinoma from May 2016 to August 2017 in our hospital were selected.According to the random number table method,they were divided into experimental group and control group,32 cases in each group.The experimental group was soaked with 400 U/mL chymotrypsin solution 10 mL for 20 minutes,and then the nasal cavity was rinsed with normal saline.The control group was soaked with saline 10 mL for 20 minutes,and then nasal lavage was done with saline.The frequency of treatment in two groups was 2 times daily.The second week after treatment,the treatment effect of the nasopharyngeal scab and mucosal inflammation was observed under the electronic nasopharyngeal laryngoscope.Result:The effective rate of nasopharyngeal mucous membrane inflammation treatment in experimental group was 62.5%,which was higher than 25.0%in control group(P<0.05).The effective rate of the nasopharyngeal scab clearance in experimental group was 78.1%,which was higher than 31.3%in control group(P<0.05).Conclusion:The patients with nasopharyngeal scab after radiotherapy are treated by intranasal infusion of chymotrypsin to soak the nasopharynx and then rinse the normal saline,can enhance the recovery of nasopharyngeal mucosa inflammation after radiotherapy of nasopharyngeal carcinoma and enhance the therapeutic effect of scab flushing of nasopharynx.

关 键 词：鼻咽癌 糜蛋白酶 鼻腔冲洗 治疗 

分 类 号：R739.63[医药卫生—肿瘤]