皮下埋入式多功能化疗泵双灌注治疗晚期肝癌

[目的] 观察经皮下埋入式多功能化疗泵治疗合并门静脉癌栓的晚期肝癌的疗效。[方法] 经皮下埋入式多功能化疗泵向肝动脉、门静脉内灌注阿霉素、丝裂霉素。[结果] 本组19例中6例癌栓消失，10例近期(3个月内)肿瘤缩小；14例肿瘤缩小，中位缩小率67．1％，部分缓解率58．8％；11例生存期超过6个月。[结论] 为合并门静脉癌栓的晚期肝癌提供有效的治疗方法。     

Advanced esophageal cancer with situs inversus totalis successfully treated with chemoradiotherapy followed by esophagectomy: case report

We report a case of advanced esophageal cancer successfully treated with neoadjuvant chemoradiotherapy followed by esophagectomy in a 53-year-old man with situs inversus totalis. Upper gastrointestinal endoscopy in a clinical examination revealed a tumor in the lower third of the esophagus, and moderately differentiated squamous cell carcinoma was diagnosed from the biopsy findings. He was referred to us and the disease was diagnosed as esophageal cancer (clinical T3N1M0, cStage III) after further evaluation. According to the therapeutic strategy of our department, neoadjuvant chemoradiotherapy was commenced. The regimen was composed of radiotherapy (2 Gy/day, 5 days/week, 4weeks, total 40Gy) with cisplatin (70 mg/m2/day, day 1) and 5-FU (700 mg/m2/day, day 1-4). We performed a subtotal esophagectomy with radical lymph node dissection through a left thoracotomy because of the existence of situs inversus totalis. The thoracic operation could be performed with relatively safety because the organs were arranged in a mirror image of their normal positions. On the other hand, it was relatively difficult to construct a gastric tube. In particular, ligation of the gastrosplenic ligaments was difficult and this led to increased blood loss compared with usual operation. Histopathological examination revealed no residual carcinoma at the site of the primary focus. The patient has been followed up periodically on an outpatient basis and has remained free of recurrence for longer than 2 years 5 months after surgery.     

电化学治疗晚期食管癌70例

目的观察电化学对晚期食管癌合并严重梗阻的治疗效果。方法应用我国研制的导管电极治疗70例晚期食管癌合并梗阻,其中65例为原发性晚期食管癌梗阻,5例为术后吻合口狭窄。全部病例均为Ⅲ、Ⅳ度梗阻,且不能接受手术或放、化疗。通过导管电极采用直流电治疗1~4次。结果完全缓解(CR)19例;部分缓解(PR)35例;稍有改善(NC)9例;病情无改善(PD)7例。总有效率(CR PR)为77.1%(54/70)。结论本方法简便易行,安全有效,创伤小、恢复快,可明显改善患者的进食梗阻,提高患者生存质量,为治疗晚期食管梗阻提供了一种新的有效方法。     

Advanced testicular cancer presenting with phlegmasia cerulea dolens

A case of fulminating deep venous thrombosis secondary to invasion of the inferior vena cava is described in a 45 year old man presenting with a germ cell tumour. Despite aggressive supportive care and emergency chemotherapy his late presentation caused his death. The case highlights the necessity for increased public education of the attendant risks in delayed presentation with a testicular lump.     

多西紫杉醇治疗晚期胃癌的进展

多西紫杉醇作为新一代的紫杉类抗癌药物，经过多年的临床研究显示，其对晚期胃癌有较好的疗效。其单药有效率在17％～24％，联合顺铂或联合5-氟尿嘧啶的有效率在20％～50％之间。最近多西紫杉醇治疗胃癌的多中心Ⅲ期临床试验结果显示，多西紫杉醇联合顺铂和5-氟尿嘧啶的中位疾病进展时间显著延长，疾病缓解率显著改善，多西紫杉醇治疗组患者6个月、9个月、1年生存率均较对照组患者有明显提高。     

肿瘤化疗中PICC导管的长期应用

1 临床资料 2004-03/2004-08将外周插管的中心静脉导管(peripherally inserted central catheter, PICC)运用于肿瘤化疗患者38 (男29,女9)例,年龄35～73(平均41)岁. 其中肺癌17例,肝癌6例,乳腺癌9例,淋巴瘤5例,胃癌1例. 初发初治30例,反复化疗8例. 采用美国巴德公司生产的蓝色PICC导管,管长60 cm,管腔容积1 mL,以后采用美国Arrow公司生产的豪华装4Fr导管. 插管前紫外线消毒治疗室,光线应充足,并备好用于穿刺的物品. PICC穿刺包、无菌手套、碘酒、乙醇、医用棉签、皮尺、止血带、无菌肝素生理盐水、可莱福输液接头、20 mL注射器、静脉穿刺包、康乐保透明贴膜、Arrow豪华包.     

Nursing of advanced colorectal cancer patients treated with Cetuximab combined with chemotherapy

Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with advanced colorectal cancer were treated with cetuximab and chemotherapy. Based on the curative effect of this combination therapy, we have concluded that the following nursing practices make an important contribution to the patients＇ prognosis and wellbeing： to establish a good nurse-patient relationship, to increase patient understanding of the side effects, to standardize the medications, to observe and to deal with the side effects of the medications（for example skin reaction, neutropenia, and diarrhea）, and to provide continuous mental health care support and education.     

口服榄香烯注射液治疗晚期胃癌临床观察

目的：观察口服榄香烯注射液治疗未手术晚期胃癌患者的疗效。方法：72例未手术晚期胃癌患者,随机分为治疗组和对照组,各36例,对照组采用常规治疗和对症支持治疗,治疗组在对照组的基础上加用榄香烯注射液口服治疗,观察患者疼痛变化、生活质量改善情况、便潜血阳性者止血效果及不良反应。结果：可评估疗效者70例（治疗组36例,对照组34例）,治疗组在生活质量（KPS评分）改善、疼痛缓解、便潜血阳性转阴方面明显高于对照组。3项对比,差异均有高度统计学意义（P〈0.01）。治疗期间未见明显毒副反应。结论：口服榄香烯注射液治疗未手术晚期胃癌效果良好,无毒副作用,使用方便,值得临床推广。     

宫颈癌新辅助化疗55例临床观察

目的 探讨术前新辅助化疗对Ⅰ b～Ⅱ b期宫颈癌高危患者的近期疗效.方法 55例宫颈癌术前采用1～3个疗程的静脉化疗后手术,观察近期疗效.结果 临床近期有效率达67.3%,手术切除率达100%.结论 术前新辅助化疗对Ⅰ b～Ⅱ b期宫颈癌高危患者有效,能明显缩小局部肿瘤,提高手术切除率,可以提高治疗效果和进一步改善生活质量.     

Nursing of advanced colorectal cancer patients treated with Cetuximab combined with chemotherapy

Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with advanced colorectal cancer were treated with cetuximab and chemotherapy. Based on the curative effect of this combination therapy, we have concluded that the following nursing practices make an important contribution to the patients'prognosis and wellbeing: to establish a good nurse-patient relationship, to increase patient understanding of the side effects, to standardize the medications, to observe and to deal with the side effects of the medications(for example skin reaction, neutropenia, and diarrhea), and to provide continuous mental health care support and education.     

肝动脉化疗栓塞术治疗肝癌的综合护理干预

目的探讨综合护理干预在肝动脉化疗栓塞术治疗原发性肝癌中的作用。方法 62例拟行肝动脉化疗栓塞术的原发性肝癌患者随机分为观察组(32例)和对照组(30例),观察组进行综合护理干预,对照组进行一般护理,观察两组患者术前焦虑状况及术后生活质量。结果观察组焦虑值明显低于对照组(P<0.05),而且生活质量明显高于对照组(P<0.05)。结论对实施肝动脉化疗栓塞术的原发性肝癌患者有必要实行综合护理干预。