«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]

期数:

2018年03期

页码:

392-395

栏目:

论著（胸部肿瘤）

出版日期:

2017-12-29

文章信息/Info

Title:

Clinical efficacy of thermotherapy in the treatment of radiation pneumonitis

作者:

杨育梁¹; 高玉华²; 唐 楠²; 李润浦²

1.保定市第二中心医院呼吸科；2.肿瘤科，河北 保定 072750

Author(s):

Yang Yuliang¹; Gao Yuhua²; Tang Nan²; Li Runpu²

1.Respiratory Department;2.Oncology Department,the 2nd Central Hospital of Baoding,Hebei Baoding 072750，China.

关键词:

热疗; 放射性肺炎; 肺功能; 疗效

Keywords:

thermotherapy; radioactive pneumonia; pulmonary function; curative effect

分类号:

R730.5

DOI:

10.3969/j.issn.1672-4992.2018.03.017

文献标识码:

A

摘要:

目的：观察深部热疗在放射性肺炎的治疗过程中对治疗效果的影响。方法：收集60例行胸部放射治疗后出现放射性肺炎的患者的病例资料，所有患者均为未行手术的肺癌患者。其为序贯或同步放化疗，放射治疗剂量为60~70 Gy（常规分割），预计生存期超过6月，放射治疗后均出现急性放射性肺炎患者，根据治疗是否行深部热疗随机分为两组，每组30例。对照组30例给予糖皮质激素与抗感染治疗，辅以吸氧、止咳、解痉平喘等对症处理；治疗组30例在对照组基础上加用深部热疗。热疗设备使用HG-2000体外局部高频热疗机，加温温度42 ℃~43 ℃，时间为40 min，隔日1次，共10次，分别检测放射性肺炎治疗前、放射性肺炎治疗后肺功能、血气分析的变化趋势。结果：治疗组放射性肺炎的总有效率、生存质量KPS评分、症状积分改善显著优于对照组（P<0.05）；治疗后两组肺功能指标（VC、FEV1）、血气分析指标（PaO2、PaCO2）均有好转，且治疗组明显优于对照组（P<0.05）；炎性因子hs-CRP、IL-6、TNF-α水平均明显下降，且治疗组好于对照组（P<0.05）。结论：深部热疗联合传统糖皮质激素治疗放射性肺炎，有助于放射性肺炎患者的症状、肺功能、血气分析、炎性指标的恢复，提高患者生活质量。

Abstract:

Objective：To observe the effect of deep thermotherapy in the treatment of radiation pneumonitis.Methods：60 cases of radioactive pneumonia patients were collected.All patients were with lung cancer and no surgery was performed，accepted the sequential or chemoradiation，radiotherapy dose for 60~70 Gy (regular).Survival was expected to more than 6 months.Patients with acute radioactive pneumonia after radiotherapy,were randomly divided into two groups according to whether accepted deep thermal therapy，each group 30 cases.The control group was treated with glucocorticoid and anti-infective drugs，accompanied by oxygen，cough，ease tracheal spasm and smooth wheezing.The treatment group accepted deep thermal therapy on the basis of control group.Heat treatment equipment was the HG-2000 in vitro local high-frequency heat treatment machine，heating temperature of 42 ℃~43 ℃，time of 40 min，1 time every other day，total 10 times.Then pulmonary function and blood gas analysis were detected before and after treatment.Results：The total effective rate，KPS score and symptom score of radiation pneumonia in treatment group were significantly better than those in control group (P<0.05).Lung function index of two groups after treatment (VC and FEV1)，blood gas analysis index (PaO2，PaCO2) were improved，and the treatment group was improved better than that of control group (P<0.05).The levels of inflammatory factors (hs-CRP，IL-6 and TNF-α) were decreased significantly，and the treatment group was better than that of the control group (P<0.05).Conclusion：Deep hyperthermia combined with traditional glucocorticoid in the treatment of radiation pneumonitis can be beneficial to the symptoms，pulmonary function，blood gas analysis，inflammatory indexes and improve the quality of life in patients with radiation pneumonitis.

参考文献/References

［1］Wang YZ.Research progress of radiation pneumonitis［J］.Chinese Cancer，2007，16(1)：39-43A.［王跃珍.放射性肺炎研究进展［J］.中国肿瘤，2007，16(1)：39-43A.］
[2]Geaham MV，Purdy JA，Emami B，et al.Clinical dose-volome histogram analysis for peneumonitis after 3D treatment for non-small cell lung cancer(NSCLC)［J］.Int J Radiat Oncol Biol Phys，1999，45（2）：323-329.
[3]Zheng XY.Guidelines for clinical research of new drugs［M］.Beijing：China Medical Science and Technology Press，2002：216-224.［郑筱萸.中药新药临床研究指导原则［M］.北京：中国医药科技出版社，2002：216-224.］
[4]Yin Weibo，Yu Zihao，Xu Guozhen，et al.Radiation oncology［M］.Beijing：Peking Union Medical College Press，2008：307-323.［殷蔚伯，余子豪，徐国镇，等.肿瘤放射治疗学［M］.北京：中国协和医科大学出版社，2008：307-323.］
[5]Tan YH，Wang D，Wang BY，et al.Clinical analysis of hormone therapy for radiation pneumonitis［J］．Chinese J Radiation Medicine and Protection，2005，25(3)：260-261.［谭永红，王东，王必友，等.放射性肺炎激素治疗临床分析［J］．中华放射医学与防护杂志，2005，25(3)：260-261.］
[6]Wu HJ，Hu QY，Zhang MY.Nursing care of internal field thermotherapy for radiation pneumonitis［J］．Nursing and Rehabilitation，2008，7(1)：32-34.［吴红娟，胡巧云，张美英．内生场热疗治疗放射性肺炎的护理［J］．护理与康复，2008，7(1)：32-34.］
[7]Graves PR，Siddiqui F，Anscher MS，et al.Radiation pulmonary toxicity：From mechanisms to management［J］.Semin Radiat Oncol，2010，20(3)：201-207.
[8]Li Shuangshuang，Kong Weiwei，Liu Baorui.Advances in research on predictors of radiation pneumonitis［J］.Modern Oncology，2015，23(8)：1152-1156.［李双双，孔炜伟，刘宝瑞.放射性肺炎相关预测指标的研究进展［J］.现代肿瘤医学，2015，23(8)：1152-1156.］
[9]Wang Q，Jiang YW，Ma YM.Advances in predictive indexes of radiation lung injury［J］.Beijing Medicine，2014，36(1)：56-59.［王倩，蒋延文，马迎民.放射性肺损伤预测指标的研究进展［J］.北京医学，2014，36(1)：56-59.］
[10]Wang DQ，Li BS.Functional and biologic metrics for predicting radiation pneumonitis in locally advanced non-small cell lung cancer patients treated with chemoradiotherapy［J］.Clin Translat Oncol，2012，14(12)：943-952.
[11]Leng QN，Zhang GW.Clinical and imaging findings of radiation pneumonitis due to chemotherapy in patients with small cell lung cancer［J］．J Practical Medical Techniques，2017，24（3）：274-275.［冷启妮，张国伟.小细胞肺癌同期放射治疗、化学治疗致放射性肺炎的临床与影像学表现［J］．实用医技杂志，2017，24（3）：274-275.］
[12]Xiao SW.Chinese application guide of clinical application of tumor hyperthermia（2017.V1.1）［J］.Chinese Journal of Radiation Oncology，2017，26（4）：369-357.［肖绍文.中国肿瘤热疗临床应用指南（2017.V1.1）［J］.中华放射肿瘤学杂志，2017，26（4）：369-357.］
[13]Pan J，Li YH，Cheng CY,et al.Effect of hyperthermia on osteosarcoma in mice and expression of HSP 70 gene in tumor tissue［J］.Journal of Henan University(Medical Science)，2016，35(4)：232-235.［潘佳，李艳华，程传耀，等.热疗对小鼠骨肉瘤的疗效及肿瘤组织HSP 70基因表达［J］.河南大学学报(医学版)，2016，35(4)：232-235.］
[14]Li MJ，Xu Y，Luan FY，et al.Clinical observation of 57 cases of radiation pneumonitis treated with microwave deep hyperthermia combined with traditional Chinese medicine prescription［J］.Chinese Practical Medicine，2015，10(23)：198-199.［李茂江，徐艳，栾福玉，等.微波深部热疗配合中药协定方治疗放射性肺炎57例临床观察［J］.中国实用医药，2015，10(23)：198-199.］
[15]Wang H，Lou JS，Gao ZW，et al.Efficacy of microwave thermotherapy combined with central venous catheter implantation in the treatment of tuberculous pleurisy［J］.Practical Clinical Medicine，2014，11（1）：15-17.［王华，娄金书，高作文，等.微波热疗联合中心静脉导管置入治疗结核性胸膜炎的疗效［J］.实用临床医学，2014，11（1）：15-17.］
[16]Liu HM，Xing XM，Yu HS.Retrospective analysis of diagnosis and treatment of radiation pneumonitis in Chinese Practical Medicine lung cancer patients［J］.Chinese Journal of Cancer Prevention and Treatment，2012，19（2）：127.［刘华敏，邢晓明，于洪升.中国实用医药肺癌患者放射性肺炎诊治回顾性分析［J］.中华肿瘤防治杂志，2012，19（2）：127.］
[17]Yue YR.Qingqi Huatan decoction combined with prednisone tablets to observe the therapeutic effect of radioactive pneumonia［J］.Modern Journal of Integrated Traditional Chinese and Western Medicine，2016，25（18）：2030-2032.［岳玉仁.清气化痰汤加减联合泼尼松片治疗放射性肺炎效果观察［J］.现代中西医结合杂志，2016，25（18）：2030-2032.］
[18]Xu SJ，Hu AM.IL-6，IL-8 and C-reactive protein and their significance in bacterial pneumonia［J］.Chin J Microecol，2015，27（6）：703.［徐绍娟，胡爱民.细菌性肺炎患者 IL-6 及 IL-8 及 C 反应蛋白的测定及其意义［J］.中国微生态学杂志，2015，27（6）：703.］
[19]Zhang JR，Liu SS，Lv Y，et al.A study of correlation between TNF-α，IL-6，ACE levels in plasma，dose-volume-histogram parameters and radiation pneumonitis［J］.China Oncology，2010，20（6）：440.［张瑾熔，刘珊珊，吕茵，等.血浆中 TNF-α、IL-6、ACE水平及DVH参数与放射性肺炎发生的相关性研究［J］.中国癌症杂志，2010，20（6）：440.］

备注/Memo

备注/Memo:

保定市科学技术研究与发展指导计划（编号：16ZF046）

常用功能

更新日期/Last Update: 1900-01-01