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1、高压氧治疗缓解宫颈癌放疗后并发症研究李启明1李宁2郑成位3,陈正堂1（第三军医大学新桥医院1.全军肿瘤研究所,2.高压氧中心重庆400037;3.第三军医大学大坪医院,放疗科重庆400000;）目的：改善由宫颈癌盆腔放射引起的严重放射性直肠炎；方法：24例宫颈癌外照射或合并近距离照射后放射性直肠炎患者，经过药物及内窥镜治疗无效者，进行2.4个大气压100%氧气；90分钟治疗；每周治疗5-7次；治疗10-28个疗程。结果：高压氧治疗结束后89%（18例患者中16例）出血症状减轻或消失；71%（17例中12例）疼痛症状缓解或消失；62%（13例中8例）排便紧迫感
2、减轻或消失。结论：高压氧治疗对于难治性放射性直肠炎有较高的有效率和耐受性是治疗这种常见、难治病例的重要选择。关键词:高压氧,放射性肠炎,宫颈癌,(1.OncologyresearchcenterofPLA2HyperbaricOxygenTherapyCenter,XinqiaoHospital,3.Riadiotherapydepartment,DapingHospital,theThirdMilitaryMedicalUniversity,Chongqing400037,China;)Purpose:Radiationproctitisisacommon
3、complicationfollowingexternalbeamradiationtherapyandbrachytherapyforcervixcancer.While95%percentofradiationinducedproctitisistemporaryandself-limiting,upto5%ofpatientsexperiencetoxicitiesthatarerefractorytoconservativemanagement.Hyperbaricoxygenhasawell-definedroleintreatingchronic
4、wounds,osteomyelitis,hemorrhagiccystitisandnecrotizingfasciitis.Wereviewedourexperiencewithhyperbaricoxygentherapyforradiationinducedproctitisinpatientsundergoingradiationtreatmentforcervixcancer.Methods:FromOctober1996toDecember2006,24patientswithradiationinducedproctitissecondary
5、tobrachytherapy(8),externalbeamradiationtherapy(6)orcombinedmodality(10)forcervixcancerweretreatedwithhyperbaricoxygentherapy.Inallpatientsprimarymedicalorendoscopicmanagementhadfailed.Patientsreceived100%oxygeninamultiplacehyperbaricchamberatapressureof2.4atmospheresabsolutefor90m
6、inutes5to7daysweeklyforanaverageof15sessions(range10to28).Results:All24casescompletedtheplannedcourseoftherapy.Ofpatientswithbleeding89%showedcompleteorpartialresolutionaftertherapy,Ofpatients62%notedcompleteresolutionoffecalurgency.Twelveofthe17patients(71%)withpainnoticedsomeimpr
7、ovementaftertherapy,althoughnopatientsreportedcompleteresolutionofrectalpain.Overall67%ofpatientshadapartialtogoodresponse,while33%showednoresponseordiseaseprogression.Conclusions:Thisseriesofpatientsshowedagoodoverallresponseratetohyperbaricoxygenforradiationinducedproctopathyafte
8、rotherattemptsatmanagement
