鸦胆子油局部强化联合支架置人术治疗中晚期食管癌的临床研究

目的研究支架置入术联合鸦胆子油局部强化治疗中晚期食管癌的临床疗效。方法将21例经临床及病理确诊为食管癌的中晚期患者随机分为治疗组和对照组，对照组采用单纯支架置人术＋鸦胆子油静脉注射治疗（方法为10％鸦胆子油乳注射液30ml和生理盐水250ml静脉滴注，每日1次）；治疗组在对照组治疗的基础上加用鸦胆子局部强化治疗（方法为胃镜下10％鸦胆子油乳注射液10ml＋肾上腺素1mg分10-20点对病灶进行注射，每点注射0．5-1．0m1）。两组的鸦胆子油静脉注射治疗治疗均为21天。观察两组治疗后的临床疗效、体力评分及术后并发症、不良反应等情况。结果随访治疗后12个月，治疗组吞咽困难症状改善明显优于对照组（P〈0．05）；治疗组KPS评分有效率优于对照组（P〈0．05）。治疗组食管再狭窄率、肺炎发生率、食管气管瘘发生率明显低于对照组（P〈0．05）。结论鸦胆子油强化注射治疗联合胃镜下支架置人术治疗中晚期食管癌临床有效、安全，可行。

Intensified local therapy with oleum fructus bruceae combined with stent implantation for mid-stage and advanced esophageal cancer

Objective To explore the clinical efficacy of intensified local therapy with oleum fructus bruceae combined with stent implantation for mid-stage and advanced esophageal cancer. Methods 21 patients pathologically confirmed as mid-stage and advanced esophageal cancer were randomly divided into study group and control group. The control group received stent implantation plus intravenous injection of oleum fructus bruceae （intravenous drip of 10% oleum fructus of 30 mL and normal saline of 250 ml once daily） ; the study group received intensified local therapy with oleum fructus bruceae in addition to the therapy used in the control group （gastroscopic local injections of 10% oleum fructus bruceae of 10 ml）. Intravenous injections of olenm fruc- tus bruceae lasted for 21 days in both groups. The clinical efficacy, physical scores, postoperative complications, and adverse reactions were observed in both groups. Results 12 months after treatment, the study group was markedly superior to the control group in relief of dysphagia （P〈0.05） and in the effectiveness rate of the KPS scores （P〈0.05）. The rate of esophageal restenosis and the incidence rates of pneumonia and esophageal fistula were significantly lower in the study group than in the control group （P〈0.05）. Conclusions Intensified local therapy with oleum fructus bruceae combined with stent implantation is safe, effective and feasible in the treat- ment of mid-stage and advanced esophageal cancer.