高压氧治疗对乳腺癌放化疗患者术后并发症及免疫功能的影响

来源 :中华航海医学与高气压医学杂志 | 被引量 : 0次 | 上传用户:mysticlisten
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目的:探讨高压氧(HBO)治疗对乳腺癌放化疗患者术后并发症及免疫功能的影响。方法:选取2015年2月至2018年2月福建省立金山医院普外科收治的100例乳腺癌术后放化疗患者,按照随机数字表法分为观察组和对照组,每组50例。对照组患者进行常规放化疗及临床对症治疗,观察组在对照组患者治疗的基础上加用HBO治疗。治疗后1周评估并记录患者皮瓣缺血坏死、皮下积液、切口感染、患肢水肿的发生情况;治疗5个疗程后,比较2组患者治疗前后WBC、PLT计数及血红蛋白(Hb)含量的变化,并检测血清免疫功能指标CD4n +、CD8n +及CD4n +/CD8n +的水平。n 结果:治疗5个疗程后,观察组患者皮瓣缺血坏死、皮下积液、切口感染发生率明显低于对照组,差异有统计学意义(n χ2=8.073,n P<0.01);观察组患者WBC、PLT计数及Hb含量均明显高于对照组(n P<0.05);观察组治疗前后免疫功能指标CD4n +、CD8n +及CD4n +/CD8n +明显高于对照组,差异均有统计学意义(n P<0.05)。n 结论:HBO辅助治疗乳腺癌术后放化疗患者可明显提高其免疫功能指标,提高PLT、WBC计数及Hb含量,且术后并发症发生率明显降低,可在临床推广应用。“,”Objective:To study the effects of hyperbaric oxygen (HBO) therapy on immune function and quality of life in patients with breast cancer undergoing radiochemotherapy.Methods:A total of 100 breast cancer patients admitted in the Department of General Surgery of Fujian Provincial Hospital South Branch from the February of 2015 to the February of 2018 were selected as the study objects, and were divided into observation group and control group according to the random number table method, with 50 cases in each group. Patients in the control group were treated with chemoradiotherapy and other routine clinical symptomatic treatments. Patients in the observation group were treated with HBO therapy on the basis of the treatments of the control group. One week after treatment, the occurrence of ischemic necrosis of flap, subcutaneous hydrops, incision infection, and edema of the affected limbs were all evaluated and recorded. After 5 courses of treatment, the changes of WBC, PLT, hemoglobin content, and serum immune function indexes, CD4n + , CD8n + , and CD4n + /CD8n + of both the two groups before and after treatment were detected and compared.n Results:After 5 courses of treatment, the occurrence of ischemic necrosis of flap, subcutaneous hydrops, incision infection, and edema of the affected limbs of the observation group were significantly lower than those of the control group (χn 2=8.073, n P<0.01). WBC and PLT counts, hemoglobin content in the observation group were significantly higher than those in the control group(n P<0.05). Compared with the control group, CD4n + , CD8n + and CD4n + /CD8n + were significantly increased in the observation group (n P<0.05).n Conclusion:HBO therapy can improve the immune function indexes of breast cancer patients after radiochemotherapy and increase PLT, WBC count, and hemoglobin content, so as to significantly reduce the incidence of postoperative complications, which is worthy of popularization and application in clinic.
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连续血液净化治疗(CBPT)又称连续肾脏替代治疗,是重症患者常用的重要治疗手段。重症患者容量耐受区间变窄,易出现容量不足或过负荷情况,影响患者预后。因此,在CBPT中,容量管理尤为重要。目标指导容量管理(GDVM)是目前CBPT的主要容量管理策略。GDVM的核心是对CBPT时液体平衡目标的设定、滴定及反馈调整,首先需要对重症患者的容量进行准确评估。进行容量评估时,既要评估血管内容量,也要对血管外容
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