高压氧联合rhGM-CSF治疗宫颈癌放疗后放射性直肠炎的疗效观察  

Efficacy of hyperbaric oxygen combined with rhGM-CSF on radiation proctitis after radiotherapy for cervical cancer

作　　者：李玉娟 闫华 黄成香 张海堂 Li Yujuan;Yan Hua;Huang Chengxiang;Zhang Haitang(Department of Gynecology,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院妇科,临沂276400

出　　处：《中华航海医学与高气压医学杂志》2025年第1期36-40,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：临沂市科技发展计划项目(201919030)。

摘　　要：目的探究高压氧(HBO)联合重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)治疗宫颈癌放疗后放射性直肠炎(RP)的疗效。方法选取2019年8月至2022年8月临沂市中心医院妇科收治的宫颈癌盆腔放疗后致RP104例患者为研究对象,按随机数字表法将患者分为研究组和对照组,每组52例。对照组患者采取常规治疗,研究组在常规治疗基础上于保留灌肠液中加用rhGM-CSF并联合HBO治疗,2组均持续治疗2周。比较2组疗效及治疗前后急性放射性损伤程度、直肠黏膜评分与血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1、IL-6]水平的差异。结果2组疗效比较差异有统计学意义(Z=5.057,P<0.05),且研究组治疗总有效率(96.15%)高于对照组(82.69%),差异有统计学意义(χ^(2)=4.981,P<0.05)。2组患者治疗后急性放射性损伤程度均较治疗前明显改善,且研究组较对照组改善更加明显,差异均有统计学意义(均P<0.05);研究组患者治疗后的直肠黏膜评分[(1.76±0.52)分]及血清TNF-α[(24.73±5.25)ng/L]、IL-1[(9.35±2.54)ng/L]、IL-6[(14.44±3.65)ng/L]水平均低于治疗前[(4.52±1.22)分、(48.64±12.81)ng/L、(22.91±5.20)ng/L、(31.87±8.52)ng/L],且低于对照组治疗后[(2.73±0.54)分、(32.40±6.66)ng/L、(13.49±3.43)ng/L、(21.48±4.27)ng/L],差异均有统计学意义(均P<0.05)。结论HBO联合rhGM-CSF治疗宫颈癌放疗后RP疗效优于常规治疗,可有效改善直肠黏膜损伤程度,减轻炎症反应。Objective To investigate the efficacy of hyperbaric oxygen(HBO)combined with recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)on radiation proctitis(RP)after radiotherapy for cervical cancer.Methods A total of 104 patients with radiation proctitis(RP)due to pelvic radiotherapy for cervical cancer,treated at the Gynecology Department of Linyi Central Hospital from August 2019 to August 2022,were included.According to the random number table method,the patients were divided into study group and control group,with 52 patients in each group.The patients in the control group were treated with the conventional treatment,while the study group received the conventional treatment combined with hyperbaric oxygen(HBO)therapy and the retention enema solution supplemented with rhGM-CSF.Both groups were treated continuously for two weeks.The efficacy,grading of acute radiation injury severity,rectal mucosa score,and the level of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-6(IL-6)]before and after treatment in the two groups were compared.Results There was a statistically significant difference between the two groups on efficacy(Z=5.057,P<0.05),with the overall effective rate of the study group(96.15%)being higher than that of the control group(82.69%),the difference was of statistically significant(χ^(2)=4.981,P<0.05).After treatment,both groups of patients showed significant improvement in the severity of acute radiation injury compared with before treatment,with the improvement being more marked in the study group compared to the control group,and the differences were statistically significant(all P<0.05).The rectal mucosa score[(1.76±0.52)points]and serum levels of TNF-α[(24.73±5.25)ng/L],IL-1[(9.35±2.54)ng/L],and IL-6[(14.44±3.65)ng/L]in the study group after treatment were lower than those before treatment[(4.52±1.22)points,(48.64±12.81)ng/L,(22.91±5.20)ng/L,(31.87±8.52)ng/L],and also lower than those in the control group after treatment[(2.73�

关 键 词：放射性直肠炎 宫颈癌 高压氧 重组人粒细胞-巨噬细胞集落刺激因子 

分 类 号：R737.33[医药卫生—肿瘤] R818[医药卫生—临床医学]