复方蛋黄乳防治头颈部肿瘤急性放射性口腔粘膜炎的疗效观察-肿瘤学(放疗)专业论文.docx

— — PAGE 1— 摘 要 复方蛋黄乳防治头颈部肿瘤急性放射性 口腔粘膜炎的疗效观察 研究生：高阳 导师：包永星 教授 摘 要 目的：应用复方蛋黄乳膏对放化疗中的头颈部肿瘤患者进行前瞻性随机对照的 临床观察，以评价其防治急性放射性口腔粘膜炎的疗效。方法：106 例 I～lV 期初诊 头颈部肿瘤患者随机分为预防组(31 例)、治疗组(42 例)和对照组(33 例)。3 组患者均 采用单纯放疗或同期放化疗，采用的放疗剂量 60Gy 以上。预防组和治疗组分别为放 疗第一天和放疗至出现口腔粘膜炎时开始使用蛋黄乳至放疗结束。采用 RTOG 标准 分别评价急性口腔粘膜炎、口腔疼痛级别。结果：吸烟人群口腔粘膜炎的发生率较 非吸烟人群的高(χ2=18.636，P=0.000)；同期放化疗口腔粘膜炎的发生率较单纯放疗 的发生率高(χ2=10.924，P=0.012)。 预防组、治疗组和对照组 3、4 级急性口腔粘膜 反应的发生率分别为 22.6%、28.6%和 78.8%，预防组与对照组比较χ2=20.219 、 P=0.000，治疗组与对照组比较χ2=18.644、P=0.000。预防组比治疗组和对照组口腔 粘膜炎的出现时间明显延长(P0.05)。预防组、治疗组和对照组 2 级以上疼痛发生率 分别 54.8％、73.8％和 81.8％，3 组之间存在差异。未见明显药物副反应。结论：吸 烟史及化疗是发生放射性口腔粘膜炎的高危因素。预防性和治疗性使用蛋黄乳可能 明显减轻急性放射性口腔反应及口腔疼痛的严重程度，有利于提高患者在放疗期间 的生活质量。 关键词：头颈部肿瘤；放化疗；复方蛋黄乳；急性放射性口腔粘膜炎 新疆医科大学医学硕士学位论文 Curative Effective Observation of Compound Yolk Emulsion in Management of Head and Neck Cancer Patients with Acute Radiation Oral Mucositis Postgraduate: Gao Yang Supervisor: Bao Yong-xing professor Abstract Objective: To evaluate the efficacy of compound yolk emulsion against acute radiation oral mucositis through a randomized controlled trial for head and neck cancer patients treated by chemotherapy and radiotherapy. Methods : From March 2009 to January 2010, a total of 106 patients with newly diagnosed stage I~IV head and neck cancer were randomly assigned to including 31 in the prevention group, 42 in the treatment group and 33in the control group. All patients received current radiotherapy or chemo-radiotherapy. Radiation dose was more than 60Gy in the three groups. Intravenous infusion of compound yolk emulsion was started when radiation started one day in the prevention group and when oral mucositis occurred in the treatment group, which was given until the end of radiotherapy. Criteria of RTOG was used to evaluate acute oral mucositis and pain degree. Results: With the incidence rate of oral mucositis, smoking history is higher than no smoking history(χ2=18.636，P=0.000); besides, chemo-radiotherapy is higher than radiotherapy(χ2=10.924，P=0.012).