摘要
目的探究高压氧辅助治疗对鼻咽癌(NPC)患者放射性脑病的脑神经保护作用。方法回顾性选取莆田学院附属医院2015年1月至2018年6月96例鼻咽癌患者作为研究对象,按随机数字表法分为对照组和观察组,每组48例。对照组采取同步放化疗(放疗采用调强放疗技术),观察组在对照组基础上采取高压氧辅助治疗。比较2组患者血氧分压(PaO2)、血清神经相关物质、认知功能、放射性脑病(REP)及死亡发生情况。结果治疗后,2组患者PaO2、血清神经元特异性烯醇化酶(NSE)及S100β水平较治疗前有明显改善(P<0.05);且观察组患者PaO2高于对照组,NSE及S100β水平分别为(25.64±1.82)ng/L和(1.94±0.21)ng/L,与对照组的(27.88±1.55)ng/L和(2.23±0.16)ng/L比较明显降低,差异有统计学意义(P<0.05)。观察组患者简易精神状态检查表(MMSE)评分及改良Barthel指数(MBI)显著增加,且改善情况均优于对照组,差异有统计学意义(P<0.05)。随访1年,观察组REP发生率为10.42%,显著低于对照组的27.08%(P<0.05);生存率和对照组比较(93.75%vs.85.42%),差异无统计学意义(P>0.05)。结论高压氧辅助治疗可通过增加大脑供氧,减少神经损伤,改善认知功能,从而降低REP发生率,对促进预后具有重要意义。
Objective To explore the protective effect of hyperbaric oxygen as an auxiliary treatment on cranial nerve in nasopharyngeal carcinoma patients with radioactive encephalopathy.Methods A total of 96 patients with nasopharyngeal carcinoma admitted to the Affiliated Hospital(Group)of Putian University from January 2015 to June 2018 were selected as the retrospective study objects and divided into control group(n=48)and observation group(n=48).The control group was treated with the conventional chemoradiotherapy(the radiotherapy adopted intensity modulated radiation),while the observation group received hyperbaric oxygen as an auxiliary treatment on the basis of the treatment of the control group.The partial pressure oxygen(PaO2)in blood,serum neuro-related substances,cognitive function,and the occurrences of radiation encephalopathy and death were compared between the two groups.Results After treatment,the levels of PaO2,serum neuron-specific enolase(NSE),and S100βin both groups were significantly improved(P<0.05).In addition,PaO2 in the observation group was higher than that in the control group,and the serum levels of NSE[(25.64±1.82)ng/L]and S100β[(1.94±0.21)ng/L]in the observation group were significantly lower than those in the control group[(27.88±1.55)ng/L,(2.23±0.16)ng/L),with statistically significant differences(P<0.05).The mini-mental state examination(MMSE)score and modified Barthel index(MBI)score of cognitive function in the observation group were significantly increased,and the improvements were better than those in the control group(P<0.05).After one-year follow-up,the incidence of radiation encephalopathy in the observation group was 10.42%,which was significantly lower than that in the control group(P<0.05).Comparing the survival rate in the observation group(93.75%)with that of the control group(85.42%),there was no statistically significant difference(P>0.05).Conclusion Hyperbaric oxygen as an auxiliary treatment can lower the incidence of radiation encephalopathy by increasing oxygen supply to brain,reducing nerve injury,and improving cognitive function,which is of great significance to improve prognosis.
作者
许俊凯
赵云辉
黄苡苹
黄雪娇
陈奇松
Xu Junkai;Zhao Yunhui;Huang Yiping;Huang Xuejiao;Chen Qisong(Department of Radiotherapy,The Affiliated Hospital(Group)of Putian University,Putian 351100,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2020年第5期531-534,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
高压氧
鼻咽癌
放射性脑病
脑神经保护
Hyperbaric oxygen
Nasopharyngeal carcinoma
Radiation encephalopathy
Cerebral nerve protection
