37例口颊癌术后腮腺瘘的放疗效果评估

目的 评估放射治疗应用于口颊癌术后腮腺瘘的疗效以及不良反应。方法 回顾性分析2010年1月-2020年1月湖南省肿瘤医院头颈外科收治的因口颊癌术后出现腮腺瘘且接受放射治疗的患者37例,所有患者均采用6-MeV电子线照射,每次2 Gy,每天1次,每周5次,照射总剂量为8~18 Gy（平均剂量9.7 Gy）,照射野包括整个腮腺区域。结果 37例接受放射治疗的腮腺瘘患者均治愈,治愈率达100%。后期随访3个月,无1例再次出现腮腺瘘。仅有1例患者出现轻微口干以及味觉改变,未观察到其他相关不良反应。结论 放疗用于口颊癌术后腮腺瘘的治疗,其起效快、效果显著、无明显的并发症,值得在临床推广应用。     

彩色多普勒超声评估诊断鼻咽癌放疗后颈动脉狭窄的效果及价值探讨

目的分析彩色多普勒超声(CDFI)诊断鼻咽癌(NPC)放疗后颈动脉狭窄的效果及价值。方法将2018年3月~2020年3月作为研究时间段,选取期间我院接诊的100例NPC放疗后颈动脉狭窄患者,均行CDFI检查,对诊断结果展开分析。结果(1)本组病例共检出5例完全闭塞(5.00%)、9例重度狭窄(9.00%)、31例中度狭窄(31.00%)、55例轻度狭窄(55.00%);(2)在颈动脉斑块类型方面,以硬斑块居多,共51例(51.00%);(3)颈动脉斑块主要累及颈总动脉(46.00%)。结论CDFI对于诊断NPC放疗后颈动脉狭窄有较好效果,能够明确颈动脉狭窄程度、斑块类型、斑块分布部位以及累及血管,值得推广。     

腹腔镜与开腹手术治疗胃十二指肠溃疡穿孔的疗效对比

【摘要】〓目的〓比较腹腔镜与开腹手术治疗胃十二指肠溃疡穿孔的临床疗效。方法〓回顾性分析腹腔镜胃十二指肠溃疡穿孔修补术及开腹胃十二指肠溃疡穿孔修补术各60例的临床资料,比较分析两种手术的手术时间、术后下床时间、住院时间、住院费用、失血量、术后使用镇痛药例数、切口美观及术后并发症等情况。结果〓腹腔镜组与开腹组比较,术后下床时间、住院时间、失血量、术后使用镇痛药例数、切口美观等均优于开腹手术组;术后并发症腹腔镜组的切口感染、腹腔残余脓肿、肠粘连等发生率均低于开腹组,差异有统计学意义(P<0.05)。结论〓腹腔镜胃十二指肠溃疡穿孔修补术与开腹手术比具有创伤小、痛苦小、康复快、住院时间短、术后并发症少、切口美观等优点,值得临床推广。     

应激性溃疡致上消化道出血患者临床诊断与治疗

目的：探讨应激性溃疡致上消化道出血患者临床诊断与治疗。方法对在我院2013年5月-2014年5月间住院治疗的45例应激性溃疡致上消化道出血患者进行回顾性分析,总结导致该病的常见病因、临床表现、治疗方法及效果。结果本组患者45例,经过内科综合治疗有效40例（有效率为88.89%）,另外5例患者由于内科综合治疗无效,中转手术治疗,成功止血4例（8.89%）,1例由于失血过多导致死亡（死亡率为2.22%）。结论内科综合治疗是治疗应激性溃疡致上消化道出血的首选和最重要的方法,内科治疗无效者应积极进行手术治疗以挽救患者的生命。     

三维适形放疗后程补量照射治疗体部恶性肿瘤的临床研究

目的：探讨三维适形放疗后程补量照射对体部恶性肿瘤的治疗价值。方法：选择体部恶性肿瘤患者180例,先行常规外照射DT 40～50 Gy（20～25 F/4～5 W）,再行三维适形放射治疗后程补量照射治疗,放射源为直线加速器15 MVX射线,利用多叶光栅实现4～6个三维适形照射野,分次治疗方法为DT 4～6 Gy/F,隔日1次,4～6次为1疗程,平均补量为DT 30 Gy（24～36 Gy）。结果：治疗后3～6个月,CT及MRI复查显示：134例原发癌中118例肿瘤缩小或消失（占88%）、46例转移癌中38例肿块明显缩小（占83%）;160例患者KPS评分均有提高（占89%）;全部病例未出现明显放疗并发症。结论：三维适形放射治疗体部恶性肿瘤疗效肯定,其后程补量结合常规放疗对于改善患者预后是有益的。     

还原型辅酶Q10治疗重型复发性阿弗他溃疡的随机、对照试验研究

目的 观察还原型辅酶Q10治疗重型复发性阿弗他溃疡（RAU）的临床疗效.方法 将64例重型RAU患者按随机数字表法分为试验组（30例）与对照组（34例）.对照组予以常规治疗,试验组在对照组的基础上口服辅酶Q10,观察相关临床指标差异性.结果 与入院时比较,试验组入院2周汉密尔顿焦虑量表（HAMA量表）、疾病不确定量表（MUIS量表）、目测模拟疼痛程度指数（VAS指数）的评分显著降低,差异有统计学意义（P＜0.05）;与对照组入院2周比较,试验组MUIS量表、VAS指数的评分显著降低,差异有统计学意义（P＜0.05）;与入院时比较,试验组入院2周超氧化物歧化酶、CD4^＋、CD4^＋/CD5^＋显著升高,差异有统计学意义（P＜0.05）,丙二醛（MAD）、纤维蛋白原含量显著降低,差异有统计学意义（P＜0.05）;与对照组入院2周比较,试验组MAD含量显著降低,CD4^＋、CD4^＋/CD5^＋显著升高,差异有统计学意义（P＜0.05）;与对照组比较,试验组溃疡持续时间明显缩短[（13.75±3.58）d比（16.89±5.17）d],差异有统计学意义（P＜0.05）;与对照组比较,试验组的起效率明显增加、无效率明显下降、总有效率明显增加,差异均有统计学意义（P＜0.05）.结论 辅酶Q10治疗重型RAU疗效确切,值得临床推广.     

铂类敏感型复发性卵巢癌治疗的研究进展

卵巢癌是妇科最重要的恶性肿瘤之一,其病死率居妇科恶性肿瘤之首。随着卵巢癌复发率的逐年增高,对复发的治疗就显得尤为重要。根据病人对铂类药物的敏感性,以初次治疗(达到临床缓解)停药后6个月为界,可将复发性卵巢癌大致分为铂类敏感型和耐药型。治疗铂类敏感性复发性卵巢癌的手段很多,包括化疗、二次手术、放疗等,现对其目前的治疗及进展情况进行综述。     

Therapeutic efficacy and safety of Kangfuxin in combination with rabeprazole in the treatment of peptic ulcer: A systematic review and meta-analysis

Background:Kangfuxin (KFX), a well-known Chinese patent medicine which extracted from Periplaneta americana, is widely used as an adjuvant in the treatment of peptic ulcers (PUs) with proton pump inhibitors (PPIs) such as rabeprazole, in China. However, no clear consensus has been reached on the efficacy for PU treatment.Methods:We searched in 7 electronic databases to find randomized controlled trials (RCTs) completed before May 31, 2020 to explore the clinical efficiency of KFX plus rabeprazole in the treatment of PU. Risk ratio (RR) corresponding to 95% confidence interval (CI) was calculated to estimate the outcomes. Publication bias was assessed by both Egger''s and Begg''s tests. Statistical analyses were performed using RevMan 5.4 and Stata version 10.0.Results:Twenty-five RCTs, comprising 2555 PU patients, were included in this study. Meta-analysis showed that, when compared with rabeprazole-based treatment alone, KFX plus rabeprazole significantly improved the healing rate (RR = 1.34, 95% CI 1.25–1.44) and overall response rate of ulcers (RR = 1.16, 95% CI 1.13–1.20), alleviated the clinical symptoms of PU (RR = 1.14, 95% CI 1.08–1.21), and reduced the recurrence of PU (RR = 0.38, 95% CI 0.24–0.61) without an increase in the occurrence of adverse events (RR = 0.92, 95% CI 0.66–1.28).Conclusion:Our study suggests that KFX combined with rabeprazole showed positive therapeutic effects and is safe for treating PU, which may provide more reliable evidence for the clinical use of KFX in the treatment of PU.     

A review of permanent marking for radiotherapy in the UK

IntroductionThis paper presents the results of a survey of the routine use of permanent marks for radiotherapy in the UK. This was undertaken to provide an overview of current practice. Permanent marks are a somewhat invasive procedure, and should be subject to scrutiny and judicious application.MethodThe authors reviewed the literature on international radiotherapy permanent marking practice. Common themes that emerged were the psychology of permanent marking and ink-type considerations, current practice and training, and safety. These were used to develop a questionnaire in order to form an overview of the use of marks nationally, and to identify any recurrent issues. The questionnaire also sought information regarding locations and numbers of permanent marks used for common treatment sites. The survey was sent to 71 departments in the UK using email.Results70% of departments responded. 62% of departments reported patients who had refused permanent marks. The reasons for refusal varied. India or drawing ink was used in 49 of the 51 departments (96%). The most common teaching method of tattooing involved combined observation and verbal coaching. Most departments had a written procedure for tattooing, but some did not. Although sharps injuries were rare, they were documented.ConclusionMost departments in the UK had encountered patient refusal of permanent marks, with breast patients representing the largest group which declined. There is variation in practice throughout the UK, and the equipment used is not specialised for tattooing purposes. Sharps injuries, although rare, do occur, and training methods are not consistent.Implications for practiceThe requirement for national guidelines is posited. Further investigation into the need for permanent marks in an era of state-of-the-art imaging technology is also required.