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紫杉醇周疗在晚期复发卵巢癌合并恶性肠梗阻中的应用体会

Application of weekly paclitaxel treatment in recurrent advanced ovarian cancer patients complicated with malignant bowel obstruction

摘要目的:探讨紫杉醇周疗在晚期复发卵巢癌合并恶性肠梗阻患者中的应用疗效及安全性。方法:回顾性分析2016年3月至2018年1月本院收治的晚期复发卵巢癌合并恶性肠梗阻42例,按照治疗方案将患者分为常规治疗组( n=16)和联合化疗组( n=26)。常规治疗组采用禁食水,胃肠减压,静脉营养,灌肠,抗炎,生长抑素抑制胃肠道分泌治疗;联合化疗组采用常规治疗联合紫杉醇周疗。分析比较两组患者临床资料、肠梗阻症状缓解、排气排便恢复、X线肠管积气积液改善、KPS功能状态评分变化。 结果:联合化疗组自觉腹痛、腹胀症状缓解率为80.77%(21/26),高于常规治疗组50.00%(8/16),差异有统计学意义( P<0.05);联合化疗组肛门排气、排便恢复率为69.23%(18/26),高于常规治疗组37.50%(6/16),差异有统计学意义( P<0.05);联合化疗组X线肠管积气、积液改善率为73.08%(19/26),高于常规治疗组37.50%(6/16),差异有统计学意义( P<0.05);联合化疗组治疗前KPS功能状态评分为(44.65±2.45)分,低于治疗后(56.69±2.20)分,差异有统计学意义( P<0.05);常规治疗组治疗前后KPS功能状态评分比较,差异无统计学意义( P>0.05)。 结论:晚期复发卵巢癌合并恶性肠梗阻,常规治疗联合紫杉醇周疗较单纯常规治疗明显改善患者腹痛、腹胀症状,恢复肛门排气、排便,减轻X线肠管积气、积液,明显改善患者一般状态和生活质量,为进一步治疗创造条件。

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abstractsObjective:To analyze the efficacy and safety of weekly paclitaxel treatment for patients with recurrent advanced ovarian cancer complicated with malignant bowel obstruction (MBO).Methods:42 patients with recurrent ovarian cancer who received treatment for MBO between March, 2016 and January, 2018 at our hospital were selected, and were divided into a routine group ( n=16) and a combination group ( n=26). The routine group were treated with water-fasting, gastrointestinal decompression, intravenous nutrition, enema, anti-inflammatory, and somatostatin inhibiting gastrointestinal secretion; in addtion, the combination group took weekly paclitaxel treatment. The clinical data, relief of bowel obstruction symptoms, recovery of exhaustion and defacation, pneumatosis and hydrops in intestine showed by X-ray, and scores of KPS functional status were compared between these two groups. Results:The relief rates of abdominal pain and distension, the recovered rate of anal exhaustion and defacation, and the improved rate of pneumatosis and hydrops in intestine showed by X-ray were higher in the combination group than in the routine group [80.77% (21/26) vs. 50.00% (8/16), 69.23% (18/26) vs. 37.50% (6/16), and 73.08% (19/26) vs. 37.50% (6/16); all P<0.05]. The score of KPS functional status was (44.65±2.45) before and (56.69±2.20) after the treatment in the combination group, with a statistical difference ( P<0.05). There was no statistical difference in the score of KPS functional status between before and after the treatment in the routine group ( P>0.05). Conclusions:Routine treatment combined with weekly paclitaxel treatment for recurrent advanced ovarian cancer complicated with malignant intestinal obstruction is better than routine treatment in improving abdominal pain and distension, exhaustion and defacation, pneumatosis and hydrops in intestine showed by X-ray, and the patients' quality of life, which makes it possible for further treatment.

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