紫杉醇联合洛铂经介入栓塞给药化疗宫颈癌的临床观察

发布时间：2018-04-01 15:33

本文选题：紫杉醇　切入点：洛铂　出处：《中国药房》2017年17期

【摘要】：目的:探讨紫杉醇联合洛铂经介入栓塞给药对宫颈癌患者的化疗疗效和安全性。方法:选取我院2010年5月-2014年3月收治的宫颈癌患者68例,按照治疗方案分为对照组和观察组,各34例。对照组患者给予注射用紫杉醇脂质体175 mg/m2加至5%葡萄糖注射液250 m L,ivgtt+注射用洛铂80 mg/m2加至5%葡萄糖注射液250 mL,ivgtt;观察组患者采用动脉穿刺插管经动脉造影选取子宫动脉和肿瘤血管,以明胶海绵栓塞,同时经穿刺导管注入注射用紫杉醇脂质体175 mg/m~2+注射用洛铂80 mg/m2+5%葡萄糖注射液10 m L。两组患者均在每个疗程第1天给药,以21 d为1个疗程,共治疗3个疗程。观察两组患者临床疗效、治疗前后T淋巴细胞亚群(CD4~+、CD8~+、CD4~+/CD8~+)水平;记录治疗过程中不良反应发生情况、治疗2年后的局部复发与转移情况,以及生存情况。结果:观察组患者治疗总有效率(85.29%)明显高于对照组(61.76%),差异有统计学意义(P0.05)。治疗前,两组患者CD4~+、CD8~+和CD4~+/CD8~+水平比较,差异均无统计学意义(P0.05);治疗后,两组患者CD4~+和CD4~+/CD8~+水平均明显升高,CD8~+水平明显降低,且观察组患者上述水平改善较对照组明显,差异均有统计学意义(P0.05)。观察组患者生存时间[(22.58±0.61)个月]明显长于对照组[(17.61±1.32)月],2年生存率(70.59%)明显高于对照组(47.06%),差异均有统计学意义(P0.05)。两组患者的疾病控制率、总不良反应发生率、局部复发与转移率比较,差异均无统计学意义(P0.05)。结论:紫杉醇联合洛铂经介入栓塞给药对宫颈癌患者的化疗疗效明确,可改善其T淋巴细胞亚群水平,且安全性较高。
[Abstract]:Objective: to investigate the efficacy and safety of paclitaxel combined with loplatin embolization in the treatment of cervical cancer. Methods: 68 patients with cervical cancer admitted in our hospital from May 2010 to March 2014 were divided into control group and observation group according to the treatment plan. 34 patients in each group were treated with paclitaxel liposome 175 mg/m2 plus 5% glucose injection 250m / L iv GTT for injection of roplatin 80 mg/m2 plus 5% glucose injection 250ml iv gtt, and patients in the observation group were treated with arterial puncture intubation via arteriography. Select uterine arteries and tumor blood vessels, After embolization with gelatin sponge and injection of paclitaxel liposome 175 mg/m~2 through puncture catheter, 10 mL / L loplatin 80 mg/m2 5% glucose injection was used for injection. The patients in both groups were given the drug on the first day of each course of treatment, 21 days as a course of treatment. Three courses of treatment were used to observe the clinical efficacy of the two groups, the level of CD4 ~ + CD8 ~ / CD4 ~ / CD8 ~) of T lymphocyte subsets before and after treatment, and to record the occurrence of adverse reactions and the local recurrence and metastasis after 2 years of treatment. Results: the total effective rate of treatment in the observation group was significantly higher than that in the control group (61.76), and the difference was statistically significant (P 0.05). Before treatment, there was no significant difference between the two groups in the levels of CD4 ~ + CD8 ~ and CD4- / -CD8 ~ ~; after treatment, there was no significant difference between the two groups. The levels of CD4 ~ and CD4 ~ / / CD8~ in the two groups were significantly increased and decreased, and the improvement of the above levels in the observation group was more obvious than that in the control group. The survival time of patients in the observation group [22.58 卤0.61months] was significantly longer than that in the control group [17.61 卤1.32months], and the 2-year survival rate was 70.59m higher than that in the control group (47.065.The difference was statistically significant (P 0.05). The disease control rate and the total adverse reaction rate of the two groups were significantly higher than those in the control group. There was no significant difference between local recurrence and metastasis rates (P 0.05). Conclusion: the chemotherapeutic efficacy of paclitaxel combined with loplatin through interventional embolization for cervical cancer patients is clear, and it can improve the level of T lymphocyte subsets in patients with cervical cancer.
【作者单位】：崇州市妇幼保健院妇科;
【基金】：四川省卫生和计划生育委员会科研课题(No.150049)
【分类号】：R737.33

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