白血病患者造血干细胞移植前单次全身照射的预后分析

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.     

不同梯度微波照射治疗静脉炎的疗效观察

①目的探讨不同功率的微波照射治疗静脉炎的疗效。②方法60例静脉炎患者,随机分为观察组和对照组,两组患者静脉炎病变程度无显著性差异（P≥0.05）。对照组采用常规方法照射治疗,观察组采用分梯度照射治疗,两组照射距离、照射时间相同。③结果观察组的治愈天数和显效天数均有提前,与对照组比较有显著性差异（P≤0.05）。④结论不同梯度微波照射可使静脉炎治愈和显效时间提前,减少患者痛苦与治疗天数,且可降低治疗费用。     

双柏散热敷加红外线照射对于缓解肾绞痛患者疼痛效果的观察及护理

目的探讨在临床中缓解肾绞痛患者疼痛有效、快捷的方法。方法本组80例肾绞痛患者,随机分为综合治疗组40例,单纯药物组40例,综合治疗组在单纯药物止痛的基础上予双柏散热敷加红外线照射。将治疗效果予以量化,比较两组止痛效果。结果两组的显效率、总有效率分别为：综合治疗组67．5％和92．5％;单纯药物组50％和75％,经χ2检验,P均〈0．05,表明两组病人的显效率和总有效率差异均有显著性,综合治疗组明显优于单纯药物止痛治疗。结论在肾绞痛的止痛治疗中,双柏散热敷外加红外线照射对于缓解肾绞痛明显优于单纯药物止痛。     

非正当化医疗照射的调查与分析

为合理使用医疗照射,综合济南市近几年医疗照射发展现状,发现存在一些非正当化医疗照射现象,究其原因主要是辐射危害认识不足以及利益驱使等,因此急需加强宣教,完善监管制度,从而保护公众的健康与安全。     

他们用爱为她疗伤

春节后的一天,一缕阳光照射到兰州军区临潼疗养院附属医院脑外科医生办公室,格外的温暖,完全没有一丝冬天的寒冷。医护人员的白大褂在阳光照射下,雪白雪白的。记者跟随医护人员来到一间特殊的病房,房内不仅有朵朵鲜花,还弥漫着浓浓的清香。他们今天要在这里送走一位特殊的病人——周亚军。"周亚军是一个精神病患者,在缺席     

手术切除联合电子线照射治疗瘢痕疙瘩的疗效分析

目的 探讨手术切除联合电子线照射治疗瘢痕疙瘩的效果.方法 2016年6月至2020年1月就诊的瘢痕疙瘩患者53例,均接受手术切除联合术后电子线照射治疗(4 Gy/次,1次/d,连续治疗5 d),术后定期随访,观察并分析本组患者的治疗效果及不良反应发生情况.结果 53例患者中,治愈46例,显效5例,治疗有效率96.23％...     

微波照射配合硫酸镁湿敷治疗化疗性静脉炎36例疗效观察

目的：观察微波照射配合硫酸镁湿敷治疗化疗性静脉炎的治疗效果。方法：36例患者随机分观察组18例,运用微波照射配合硫酸镁湿敷治疗;对照组18例,用硫酸镁湿敷治疗。2组均连续治疗7天后进行疗效比较。结果：观察组总有效率为88.9%,对照组为66.7%。2组总有效率比较,差异有非常显著意义（P〈0.01）。结论：微波照射配合硫酸镁湿敷能有效治疗化疗性静脉炎。     

肝硬化肝癌立体定向照射后细胞因子表达的实验研究

目的应用兔肝硬化肝癌模型观察肝病状态下肝癌照射后放射性肝损伤的细胞因子变化。方法肝硬化肝癌兔16只(实验组1),随机分为两组,每组8只,分别给予单次剂量20,30Gy的立体定向照射;8只单纯接种肝癌兔(实验组2),随机分为两组,每组4只,按上述方法分别给予相同照射。照射后3周全部处死,应用EV二步法分别观察照射后实验组1与实验组2兔肝组织GST-π的变化。结果①给予20Gy照射,实验组1GST-π在癌周组织的表达比实验组2GST-π的表达高,两组间差异有显著性(P=0.010);②给予30Gy照射,实验组1GST-π在癌周组织的表达与实验组2GST-π的表达相似,两组间差异无显著性(P=1.000);③实验组1不同剂量照射后,高剂量组(30Gy)GST-π在癌周组织和肝癌组织的表达比低剂量组(20Gy)的表达低,两组间差异有显著性(P=0.010)。结论①实验性肝硬化肝癌的照射效果单次剂量30Gy优于20Gy;②GST-π可作为评价肝硬化肝癌照射效果的参考指标。     

局部冰敷加TDP照射在关节镜术后康复中的应用

关节镜检查是指在手术室内使用内窥镜深入关节腔内进行诊断检查和某些治疗操作的一种比较安全实用的新技术。其是在一根细管的端部装有一个透镜,将细管插入关节内部,关节内部的结构便会在监视器上显示出来,因此,可以直接观察到关节内部的结构。     

肺癌化疗后放射治疗致急性肺损伤的X线表现

目的：探讨化疗加放射治疗产生急性肺损伤的X线表现。方法：对具有特征性X线表现的11例化疗加放射治疗产生急性肺损伤病例进行回顾性分析。结果：①两肺广泛间质性改变：两肺透光度差，呈磨玻璃样变7例(63．6％)。两肺纹理强、模糊、紊乱，呈网状8例(72．7％)，伴有弥漫颗粒状影4例(36％)。②两肺小叶性炎症改变3例(2．7％)，表现为小斑片状密度增高影，边缘模糊，密度不均，可融合成大小不等的片状影，照射野内更为明显，有跨叶、跨段分布的特点，而单纯放射性肺炎特征性X线表现为：照射野范围内高密度模糊小片状或大片状影，其分布形态与放疗照射野相一致。结论：化疗后放疗急性肺损伤的特征性X线表现为：①病变以间质性改变为主；②病变范围广与单纯放射性肺炎不符；③短期复查胸片病变形状有变化；④临床症状重多伴有呼吸困难甚至呼吸衰竭；⑤经大量抗炎加激素治疗后随访胸片显示两肺野透光度增强，小叶性炎症病变逐渐吸收，但间质性病变仍然存在。⑥早期行X线或CT检查，有助于提高诊断准确率，达到早治疗的目的。