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重组人血管内皮抑制素结合CT引导下经皮穿刺微波消融术治疗晚期NSCLC合并COPD的临床观察
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| 篇名： | 重组人血管内皮抑制素结合CT引导下经皮穿刺微波消融术治疗晚期NSCLC合并COPD的临床观察 |
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| 摘要： | 目的：观察重组人血管内皮抑制素结合CT引导下经皮穿刺微波消融术治疗晚期非小细胞肺癌（NSCLC）合并慢性阻塞性肺疾病（COPD）的临床疗效及安全性。方法：选择2014年2月－2016年2月我院收治的80例晚期NSCLC合并COPD患者，按随机数字表法分为对照组和观察组，各40例。对照组患者给予CT引导下经皮穿刺微波消融术治疗；观察组患者在对照组基础上加用重组人血管内皮抑制素注射液7.5 mg/m2静脉滴注，4 h滴完，d1～14，连续治疗14 d后休息7 d再进行下一周期治疗。每个治疗周期为21 d，共治疗4个周期。比较两组患者的生存时间、临床疗效、治疗前后的卡氏（KPS）评分和肺功能指标，以及不良反应发生情况。结果：观察组患者的中位生存时间（19.8个月）明显长于对照组（15.2个月），总有效率（72.5％）明显高于对照组（55.0％），差异均有统计学意义（P＜0.05）。治疗前，两组患者的KPS评分、1 s用力呼气容量（FEV1）、FEV1/用力肺活量（FVC）和肺一氧化碳弥散量（DLCO）比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的KPS评分和上述肺功能指标水平均较治疗前明显升高，且观察组均明显高于对照组，差异均有统计学意义（P＜0.05）。两组患者均未见Ⅳ级不良反应发生，各级别不良反应发生例数比较，差异均无统计学意义（P＞0.05）。结论：重组人血管内皮抑制素结合CT引导下经皮穿刺微波消融术治疗晚期NSCLC合并COPD的临床疗效较好、不良反应较轻，能明显改善患者的肺功能和生存质量。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of recombinant human endostatin （rh-endostatin） combined with CT-guided percutaneous microwave ablation in the treatment of non-small cell lung cancer （NSCLC） complicated with chronic obstructive pulmonary disease （COPD）. METHODS： A total of 80 cases of NSCLC complicated with COPD were selected from our hospital during Feb. 2014-Feb. 2016， and then divided into control group and observation group according to random number table， with 40 cases in each group. Control group was treated by CT-guided percutaneous microwave ablation. Observation group was additionally given rh-endostatin injection 7.5 mg/m2， once a day， d1-14， added into 500 mL 0.9％ sodium chloride injection， ivgtt lasting for 4 h， for consecutive 14 d， on the basis of control group； 7 d later， next course was performed. A treatment course lasted for 21 d， and they received 4 courses of treatment. Survival time， clinical efficacy as well as KPS score and lung function indexes before and after treatment， the occurrence of ADR were compared between 2 groups. RESULTS： Median survival time of observation group （19.8 months） was significantly longer than that of control group （15.2 months）， and total response rate of observation group （72.5％） was significantly higher than that of control group （55.0％）， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in KPS score， FEV1， FEV1/FVC or DLCO between 2 groups （P＞0.05）. After treatment， KPS score and above lung function indexes levels of 2 groups were increased significantly， and those of observation group were significantly higher than those of control group， with statistical significance （P＜0.05）. No grade Ⅳwas found in 2 groups. There was no statistical significance in the cases of ADR at different levels between 2 groups （P＞0.05）. CONCLUSIONS： rh-endostatin combined with CT-guided percutaneous microwave ablation in the treatment of NSCLC complicated with COPD show good clinical efficacy with less ADR， and can significantly improve lung function and quality of life. |
| 期刊： | 2017年第28卷第26期 |
| 作者： | 伍成德，卢伟，战跃福 |
| AUTHORS： | WU Chengde，LU Wei，ZHAN Yuefu |
| 关键字： | 重组人血管内皮抑制素；CT引导下经皮穿刺微波消融术；非小细胞肺癌；慢性阻塞性肺疾病；肺功能；生存质量 |
| KEYWORDS： | Recombinant human endostatin； CT-guided percutaneous microwave ablation； Non-small cell lung cancer； Chronic obstructive pulmonary disease； Lung function； Quality of life |
| 阅读数： | 268 次 |
| 本月下载数： | 4 次 |
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