榄香烯注射液在食管癌围手术期治疗中的临床观察  

Clinical observation of elemene injection in perioperative treatment of esophageal cancer

作　　者：张锡轩 周斌[1] 王海波[1] 宫强[1] 李贲[1] 郭强[1] 李鹤飞[1] Zhang Xixuan;Zhou Bin;Wang Haibo;Gong Qiang;Li Ben;Guo Qiang;Li Hefei(Department of Thoracic Surgery,Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]河北大学附属医院胸外科,保定071000

出　　处：《国际肿瘤学杂志》2020年第9期518-523,共6页Journal of International Oncology

基　　金：吴阶平医学基金会临床科研项目(320.6750.17337)。

摘　　要：目的观察榄香烯注射液在食管癌围手术期治疗中的临床效果。方法选取2017年1月至2018年7月于河北大学附属医院行手术治疗的食管癌患者180例,按照计算机产生的随机序列号分为试验组(n=90)和对照组(n=90),试验组术中胸腔冲洗、淋洒留置榄香烯注射液并术后静脉滴注;对照组术中应用生理盐水胸腔冲洗。观察两组安全性指标、近期疗效指标、免疫指标、肿瘤标志物水平、远期获益指标。结果试验组白细胞增多、血小板减少、血红蛋白减少、肌酐升高、转氨酶升高、恶心呕吐发生率分别为43.33%(39/90)、0(0/90)、5.55%(5/90)、6.67%(6/90)、4.44%(4/90)、0(0/90),对照组分别为53.33%(48/90)、1.11%(1/90)、2.22%(2/90)、4.44%(4/90)、7.78%(7/90)、1.11%(1/90),两组差异均无统计学意义(χ^(2)=1.802,P=0.179;P=1.000;χ^(2)=0.595,P=0.441;χ^(2)=0.424,P=0.515;χ^(2)=0.871,P=0.351;P=1.000)。试验组术后拔管时间为(173.36±41.09)h,术后住院时间为(14.82±4.35)d,Karnofsky功能状态(KPS)评分为(81.43±3.89)分,对照组分别为(175.76±40.46)h、(15.34±5.22)d、(80.49±2.67)分,两组间差异均无统计学意义(t=-0.395,P=0.695;t=-0.726,P=0.472;t=1.890,P=0.061)。试验组引流液总量为(665.39±201.31)ml,吻合口瘘发生率为1.11%(1/90),明显低于对照组的(732.67±213.84)ml和8.89%(8/90),差异均具有统计学意义(t=-2.173,P=0.032;χ^(2)=4.211,P=0.040)。治疗前,两组患者免疫功能指标差异均无统计学意义(均P>0.05)。手术后1周复查,两组的CD3+差异无统计学意义[(55.45±6.96)%vs.(53.71±6.54)%,t=1.728,P=0.087];试验组的CD4+、CD4+/CD8+、NK细胞较对照组升高,差异均有统计学意义[(29.43±5.05)%vs.(25.92±8.06)%,t=3.501,P=0.001;1.30±0.21 vs.1.23±0.20,t=0.229,P=0.028;(254.20±15.21)个/μl vs.(237.05±10.73)个/μl,t=2.741,P=0.007]。试验组肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)水平分别为(1.37Objective To observe the clinical effect of elemene injection in the perioperative treatment of esophageal cancer.Methods A total of 180 patients with esophageal cancer who underwent surgical treatment in the Affiliated Hospital of Hebei University from January 2017 to July 2018 were selected and divided into the experimental group(n=90)and the control group(n=90)according to the random sequence number generated by the computer.In the experimental group,the thoracic cavity was rinsed and the elemene was instilled and intravenously instilled.The control group was treated with normal saline.Safety indexes,short-term efficacy indexes,immune indexes,tumor marker levels and long-term benefit indexes were observed in the two groups.Results The incidences of leukocytosis,thrombocytopenia,low hemoglobin,elevated creatinine,transaminase elevation,nausea and vomiting in the experimental group were 43.33%(39/90),0(0/90),5.55%(5/90),6.67%(6/90),4.44%(4/90)and 0(0/90),those in the control group were 53.33%(48/90),1.11%(1/90),2.22%(2/90),4.44%(4/90),7.78%(7/90)and 1.11%(1/90),and there were no significant differences between the two groups(χ^(2)=1.802,P=0.179;P=1.000;χ^(2)=0.595,P=0.441;χ^(2)=0.424,P=0.515;χ^(2)=0.871,P=0.351;P=1.000).The postoperative extubation time in the experimental group was(173.36±41.09)h,the postoperative hospital stay was(14.82±4.35)d,the Karnofsky functional status(KPS)score was 81.43±3.89,and those in the control group was(175.76±40.46)h,(15.34±5.22)d and 80.49±2.67,respectively.The differences between the two groups were not statistically significant(t=-0.395,P=0.695;t=-0.726,P=0.472;t=1.890,P=0.061).The total amount of drainage fluid in the experimental group was(665.39±201.31)ml,and the incidence of anastomotic fistula was 1.11%(1/90),which were significantly lower than those in the control group[(732.67±213.84)ml and 8.89%(8/90)],with statistically significant differences(t=-2.173,P=0.032;χ^(2)=4.211,P=0.040).Before treatment,there were no statistically significant differences in im

关 键 词：食管肿瘤 榄香烯 吻合口瘘 

分 类 号：R735.1[医药卫生—肿瘤]