氨磷汀预防化疗所致口腔黏膜炎的效果观察

目的观察氨磷汀对化疗所致口腔黏膜炎的预防效果。方法2009年11月-2010年11月16例恶性血液病患者共接受102个疗程化疗,其中同时给予氨磷汀的58个疗程设为治疗组,未给予氨磷汀的44个疗程作为对照组,比较两组口腔黏膜炎的发生率。结果治疗组口腔黏膜炎发生率低于对照组。结论氨磷汀对化疗所致口腔黏膜炎的预防效果良好。     

鼻咽癌放化疗发生严重放射性口腔黏膜炎的相关因素探讨

目的探讨鼻咽癌患者在综合治疗中发生严重放射性口腔黏膜炎的相关因素,寻找相应的早期预防和干预措施,并建立发生严重口腔黏膜炎的预测模型,为临床治疗提供参考。方法对221例鼻咽癌患者的10项临床指标进行单因素分析和多因素COX回归分析,根据COX回归分析结果建立预后指数(PI)方程,并按PI值将患者划分为严重口腔黏膜炎高发组和低发组,比较其口腔黏膜炎发生率的组间差异。结果多因素COX回归分析提示同步放化疗、口腔护理差、采用常规放疗方法是发生严重口腔黏膜炎的高危因素,PI值0.2201的患者严重口腔黏膜炎发生率高于PI值≤0.2201患者,差异有统计学意义(P0.01)。结论同步放化疗、口腔护理差、采用常规放疗方法是发生严重口腔黏膜炎的高危因素。PI值能较好地预测严重放射性口腔黏膜炎的发生,为临床进行预防和治疗提供参考。     

鼻咽癌放射治疗患者放射性口腔黏膜反应的护理干预

目的探讨鼻咽癌放射治疗患者放射性口腔黏膜反应的护理干预措施。方法对2010年1月至2013年12月我院收治并接受放疗的93例鼻咽癌患者采取积极的护理干预。结果本组93例患者中出现口腔黏膜炎Ⅰ级54例(占58.1%)、Ⅱ级31例(占33.3%)、Ⅲ级7例(占7.5%)、Ⅳ级1例(占1.1%),经积极处理和综合护理干预,除1例Ⅳ级口腔黏膜患者因影响进食而延期完成治疗外,其他病例均按计划顺利完成放射治疗,无中途退出者。结论采取积极的综合护理干预有助于减轻口腔黏膜反应、促进口腔黏膜修复,对保证鼻咽癌患者顺利完成放射治疗具有重要意义。     

思密达局部喷洒对放射性口腔黏膜炎的防治效果观察

放射性口腔黏膜炎是鼻咽癌患者放疗后常见并发症,防治困难。2007年1月-2009年2月,我们在30例鼻咽癌患者放疗过程中采用局部喷洒思密达的方法防治口腔黏膜炎,疗效满意。现报告如下。     

鼻咽癌放疗致严重口腔反应的护理体会

1999～2001年，我院对35例鼻咽癌患者行放射治疗，其中18例口腔反应严重，经过精心护理，取得较好疗效，现报告如下。     

复方黄柏液对大鼠TNBS结肠炎的治疗机制探讨

背景：临床上采用复方黄柏液保留灌肠辅助治疗溃疡性结肠炎（UC）疗效满意,但其作用机制尚不清楚。目的：探讨复方黄柏液对三硝基苯磺酸（TNBS）诱发的大鼠结肠炎模型炎症损伤的治疗作用及其可能机制。方法：40只成年雌性Sprague-Dawley大鼠随机分成四组,正常对照组不予处理,其余三组以TNBS／乙醇溶液灌肠制作结肠炎模型后．分别予0．9％NaCl溶液1ml、5-氨基水杨酸（5-ASA）200mg／kg和复方黄柏液1ml灌肠,连续14d。治疗后评估大鼠疾病活动指数（DAI）以及结肠大体、组织学损伤情况;检测结肠组织髓过氧化物酶（MPO）活性和白三烯B4（LTB4）含量;心脏采血,流式细胞术检测中性粒细胞凋亡率。结果：与正常对照组相比,TNBS模型组DAI、结肠大体和组织学评分、结肠组织MPO活性和LTB。含量均显著升高,血中性粒细胞凋亡率显著降低（P〈0．01）;5-ASA治疗组和复方黄柏液治疗组上述指标均较TNBS模型组显著改善（P〈0．01）,两组间差异则无统计学意义。结论：复方黄柏液灌肠对大鼠TNBS结肠炎具有明显治疗作用,促进中性粒细胞凋亡、清除结肠局部损伤因子（MPO、LTB。）可能为其作用机制之一。     

二甲双胍+阿卡波糖+复方黄柏液治疗糖尿病合并肛周脓肿效果分析

目的 分析二甲双胍+阿卡波糖+复方黄柏液治疗糖尿病合并肛周脓肿效果。方法 选取2020年1月—2022年12月福建省福州市连江县医院外一科收治的102例糖尿病合并肛周脓肿患者作为研究对象,以随机数表法分组,观察组(51例,二甲双胍+阿卡波糖治疗)与对照组(51例,二甲双胍治疗),两组均行复方黄柏液治疗。比较两组生活质量、血糖控制情况、治疗效果。结果 治疗前,两组生活质量综合评定量表-74各项评分比较,差异无统计学意义(P>0.05);治疗后,观察组各项评分均较对照组更高,差异有统计学意义(P<0.05)。治疗前,比较两组空腹血糖、餐后2 h血糖,差异无统计学意义(P>0.05);治疗后,观察组空腹血糖、餐后2 h血糖均较对照组更低,差异有统计学意义(P<0.05)。观察组治疗有效率98.04%高于对照组的82.35%,差异有统计学意义(χ²=7.096,P<0.05)。结论 对糖尿病合并肛周脓肿患者实行二甲双胍+阿卡波糖+复方黄柏液治疗,能有效改善生活质量,调控空腹血糖及餐后2 h血糖水平,提高临床治疗有效率。     

増液解毒汤治疗头颈部恶性肿瘤急性放射性口腔黏膜炎临床疗效观察

目的观察増液解毒汤治疗头颈部恶性肿瘤急性放射性口腔黏膜炎的临床疗效。方法选取达州市中心医院2015-03~2016-07收治的头颈部恶性肿瘤患者共118例,随机分为试验组(n=59)和对照组(n=59)。两组均行同步放、化疗,试验组给予増液解毒汤煎服,对照组给予常规含漱液,观察两组口腔黏膜反应的情况。结果 (1)放疗20 Gy时,两组均出现不同程度黏膜反应,试验组为25.86%,对照组为44.64%。(2)放疗结束时,试验组口腔黏膜副作用发生率为56.90%,对照组为71.43%;试验组3、4级发生率为6.90%,对照组为17.86%。(3)对照组延迟放疗患者比率为28.57%,试验组为15.52%。(4)口腔黏膜炎给予其他干预治疗为对照组30.36%,试验组为13.79%。以上两组结果差异均有统计学意义(P0.05)。结论増液解毒汤能减轻患者急性口腔黏膜炎的程度,降低放疗时间延长率,减少其他干预治疗措施,值得临床推广。     

70岁及以上老年鼻咽癌的放射治疗

目的 了解高龄鼻咽癌患者放射治疗特点.方法 收集1999年1月至2003年12月间在我科初次住院的38例70岁以上老年鼻咽癌患者的临床资料进行回顾性分析.结果 全组患者1、3、5年总生存率分别为57%、34%、18%;其1、3、5年肿瘤相关生存率分别为85%、68%、47%.结论 放疗能够改善高龄鼻咽癌患者的预后,部分放疗耐受性差的患者预后差;高龄鼻咽癌患者非肿瘤性死亡的概率较大.     

复方丹参药膜治疗口腔扁平苔藓82例效果观察

2005年1—12月，我们采用复方丹参药膜治疗口腔扁平苔藓（OLP）82例，效果满意。现报告如下。     

中性粒细胞和淋巴细胞与鼻咽癌口腔黏膜炎及肿瘤消退率的关联性分析

［摘要］　目的　探讨鼻咽癌患者中性粒细胞（NEUT）、淋巴细胞计数(LY)与鼻咽癌放射性口腔黏膜炎程度和肿瘤消退率之间的关系以及放疗前后的动态变化规律。方法　选择首诊鼻咽癌患者68例为实验对象（观察组）,采集入院时、放疗后第2、3、4、5、6、7周以及放疗结束、放疗后3个月患者血清标本,采用全自动血细胞分析仪分别检测患者外周血白细胞(WBC)、NEUT和中性粒细胞比例（NEUTR）、LY和淋巴细胞比例（LYR）、中性粒细胞和淋巴细胞比例（NLR）;另同期选择40名健康者作对照（对照组）。结果　鼻咽癌患者WBC、NEUT、NEUTR、LY、LYR及NLR与对照组比较差异无统计学意义(P均>0.05);治疗后NEUTR和NLR明显高于治疗前(P均<0.01);治疗后WBC、LY、LYR明显下降(P均<0.01)。放疗后第3、4、5、6、7周、放疗结束时及放疗后3个月患者的NEUTR均与同期口腔黏膜炎分级有关（P均<0.05）。治疗前后LYR变化与放疗结束时肿瘤消退率有关（P=0.048）。治疗期间口腔黏膜损伤程度与治疗结束时疗效有关（P=0.012）。结论　治疗期间监测中性粒细胞比例有助于判断放射性口腔黏膜损伤程度。治疗期间定期评价放射性口腔黏膜损伤程度,有助于预测肿瘤的近期疗效。     

复方苦参注射液联合适形调强放疗治疗鼻咽癌的临床研究

目的探讨复方苦参注射液联合适形调强放疗对鼻咽癌患者的减毒增效作用,为中药联合放疗提供临床依据。方法136例鼻咽癌患者(Ⅰ~Ⅱ期)随机分为对照组和治疗组,两组在相同条件下采用瑞典医科达直线加速器适形调强放疗,治疗组同时加用复方苦参注射液。对两组患者放疗前后的疗效进行比较。结果放疗后治疗组原发病灶正电子发射断层显像-X线计算机断层成像检查标准吸收值降低明显高于对照组,患者局部黏膜反应明显减轻。对照组患者口咽部感染率高。治疗组全组完成放疗,抗感染治疗率明显低于对照组,免疫效应细胞比例增多。结论适形调强放疗治疗鼻咽癌期间联合复方苦参注射液可提高放疗反应率,减轻放疗副作用,增强免疫细胞杀伤效应。     

Effects of oral care on development of oral mucositis and microorganisms in patients with esophageal cancer

We evaluated the effects of special oral care using a toothbrush with combined irrigation and suctioning functions, along with povidone-iodine to treat oral bacteria and mucositis, in esophageal cancer patients undergoing chemoradiotherapy. In the special care group, oral hygiene was performed 3 days a week after dinner. Bacteria in saliva and plague samples were measured at various sampling points after chemoradiotherapy. The incidence of mucositis was significantly reduced in the special care group in comparison with the control group. Total streptococci were significantly decreased in the opportunistic pathogens-positive and lower-level mutans streptococci control group during chemoradiotherapy, but they were not reduced in the opportunistic pathogens-negative and higher-level mutans streptococci control groups or in the special care group. Our results showed that a special oral care regimen enabled the total population of streptococci microflora to remain stable, was negatively correlated with opportunistic pathogens and positively correlated with mutans streptococci infection, and prevented the development of mucositis.     

Cerebral radionecrosis in patients with nasopharyngeal carcinoma

This study involved seven patients with cerebral radionecrosis following radiation therapy for nasopharyngeal carcinoma (NPC). Their charts were reviewed and the relationship of extracranial malignancies to cerebral radionecrosis was investigated. The radiation dose ranged from 70 to 135 Gy, and the latency was from 6 to 39 months. Two of seven patients died of NPC-related complications during follow-up. The crude incidence of cerebral radionecrosis in patients with NPC was 0.93% in our series. Improvement of symptoms could be achieved by corticosteroid therapy, with or without surgery. In a review of the literature, there were 306 cases of cerebral radionecrosis in extracranial malignancies. The nasopharynx is the most common primary site in cerebral radionecrosis of extracranial malignancies, followed by the scalp and sinonasal tract. The 3-year overall survival rate in our series was 68.57%, as provided by the Kaplan-Meier product limited method. Cerebral radionecrosis in NPC patients should be differentiated from tumor recurrence, in order to apply the appropriate treatment.     

Malaria antibody levels in patients with nasopharyngeal carcinoma

The antibody titres to P. falciparum and Epstein-Barr Virus-associated antigens were assayed in 22 patients with NPC and 43 controls. All, but one patient had antimalarial titres; 14 had titres greater than 80 and 4 patients greater than 640. Compared to controls the mean anti-malarial titre for most age groups were higher in the patients. Those patients with high anti-malarial titres also had high IgA anti-VCA titre, an antibody which has been demonstrated to be diagnostic for NPC. The peak anti-VCA (IgG) and anti-EA (IgG) antibody titres were associated with anti-falciparum titres of 320-640 and 80-160, respectively. The results are discussed in relation to the possible association between malarial infection and etiology of NPC.     

Suppressed cellular immunity in patients with nasopharyngeal carcinoma

The subsets and functions of lymphocytes were investigated in patients with nasopharyngeal carcinoma (NPC). The patients were divided into two groups comprising tumor-bearing patients and those in remission. There was no difference in the proportion of T cells among tumor-bearing, remission and healthy control groups. The percentages of inducer/helper T cells and natural killer cells were smaller in the tumor-bearing group than in the control group whereas the percentage of suppressor T cells was greater in the tumor-bearing group. Phytohemagglutinin-stimulated blastogenesis was markedly suppressed in the tumor-bearing group. The responsiveness to interleukin-2 of blastogenesis and of natural killer and lymphokine-activated killer activities was lowered in the tumor-bearing group. These parameters in the remission group were intermediate between those of the tumor-bearing and control groups. These results suggest that cellular immunity is suppressed in patients with NPC and that the suppressed condition still remains even in remission. Immunotherapy is considered to be indispensable for the proper treatment of NPC.Abbreviations IL-2 interleukin-2 - LAK lymphokine-activated killer - NK natural killer - NPC nasopharyngeal carcinoma - PHA phytohem-agglutinin     

鼻咽癌患者营养状态变化调查

目的:观察接受诱导化疗继之同步放化疗治疗的鼻咽癌患者治疗过程中营养状态变化情况。方法:纳入117例鼻咽癌初治患者,采用主观整体营养状况评量表(PG-SGA)在治疗及随访过程中定期进行问卷式调查,同时行血红蛋白及血清前白蛋白等血液学检查,了解患者的营养状态。结果:鼻咽癌患者接受诱导化疗继之同步放化疗后出现血红蛋白及血清前白蛋白水平减低的百分比均显著增加,治疗后缓慢恢复;主观整体营养状态在诱导化疗后略有改善,同步放化疗后显著恶化,治疗后12个月内缓慢恢复至治疗前水平。结论:接受诱导化疗继之同步放化疗的鼻咽癌患者,血清营养状态及主观营养状态在治疗过程中均会明显受化疗及同步放化疗影响,应重视患者治疗过程中营养状态的变化,给予患者个体化饮食咨询和积极的营养支持治疗。