硫糖铝保留灌肠预防宫颈癌患者急慢性放射性直肠损伤的临床观察

临床肿瘤学杂志 ›› 2022, Vol. 27 ›› Issue (03): 244-249.

硫糖铝保留灌肠预防宫颈癌患者急慢性放射性直肠损伤的临床观察

收稿日期:2021-01-29 修回日期:2022-01-14 出版日期:2022-03-25 发布日期:2022-05-12

Clinical observation of sucralfate retention enema on preventing acute and chronic radiation proctitis in patients with cervical cancer

Received:2021-01-29 Revised:2022-01-14 Online:2022-03-25 Published:2022-05-12

摘要/Abstract

摘要： 目的探讨放疗期间同步硫糖铝保留灌肠对预防宫颈癌放疗患者急、慢性放射性直肠损伤的效果，并评估对临床症状和生活质量的影响。方法收集2017年1月至2019年6月接受放疗的宫颈癌患者208例，按随机数字表法分为试验组（n=104）和对照组（n=104）。试验组放疗期间同步硫糖铝保留灌肠每晚1次。采用RTOG/EORTC标准、简单临床结肠炎活动指数（SCCAI）问卷和炎症性肠病生活质量指数（IBDQ）问卷对所有患者进行评估。结果试验组与对照组急性放射性直肠损伤的发生率分别为35.6%和58.5%（P=0.000），出现急性放射性直肠损伤的时间分别为21.3天和17.4天（P=0.000）；试验组分别有19例、15例、3例发生1级、2级、3级急性放射性直肠损伤，对照组分别为22例、31例、8例。试验组与对照组慢性放射性直肠损伤的发生率分别为9.6%和22.1%（P=0.012），出现慢性放射性直肠损伤的时间分别为10.1个月和9.2个月（P=0.235）；试验组分别有3例、4例、2例、1例发生1级、2级、3级、4级慢性放射性直肠损伤，对照组分别为4例、9例、8例、2例。与对照组比较，试验组患者在放疗结束时、放疗结束3个月和12个月SCCAI评分均低于对照组（P<0.05），而IBDQ评分则高于对照组（P<0.05）。结论放疗期间同步硫糖铝保留灌肠能有效降低宫颈癌患者发生急、慢性放射性直肠损伤的风险，并有效改善患者的临床症状和生活质量。

关键词: font-size:10.5pt, 宫颈癌')">">宫颈癌, 放射性直肠损伤, 硫糖铝, 保留灌肠

Abstract: Objective To investigate the efficacy of simultaneous sucralfate retention enema during radiotherapy on preventing the occurrence of acute and chronic radiation proctitis in patients with cervical cancer, and to evaluate the impact on the clinical symptoms and quality of life. Methods From January 2017 to June 2019, 208 cases of cervical cancer patients underwent radiation were enrolled in this study, and they were divided into experimental group (n=104) and control group (n=104) according to the random number table method. Patients in experimental group received simultaneous sucralfate retention enema during radiotherapy once daily. RTOG/EORTC table, simple clinical colitis activity index (SCCAI) questionnaire and inflammatory bowel diseases questionnaire (IBDQ) were used to evaluate all patients. Results The incidences of acute radiation proctitis in experimental group and control group were 35.6% and 58.5%, respectively (P=0.000), and the occurrence of acute radiation proctitis was 21.3 days and 17.4 days (P=0.000). Grade 1, grade 2 and grade 3 acute radiation proctitis were found 19,15 and 3 cases in experimental group, and 22, 31 and 8 cases in control group. The incidences of chronic radiation proctitis in experimental group and control group were 9.6% and 22.1%, respectively (P=0.012), and and the occurrence of chronic radiation proctitis was 10.1 months and 9.2 months, respectively (P=0.235). Grade 1, grade 2, grade 3 and grade 4 chronic radiation proctitis were found 3, 4, 2, and 1 cases in experimental group and 4, 9, 8 and 2 cases in control group. Patients in experimental group had lower SCCAI scores than the control group at the end of radiotherapy, 3 months and 12 months after radiotherapy (P<0.05), while the IBDQ score was higher than that in the control group (P<0.05). Conclusion Sucralfate retention enema during radiotherapy can effectively reduce the risk of acute and chronic radiation proctitis in patients with cervical cancer and improve the patients' clinical symptoms and quality of life.

Key words: font-size:10.5pt, Cervical cancer">Cervical cancerfont-size:10.5pt, ')">">, font-size:10.5pt, Radiation proctitis">Radiation proctitisfont-size:10.5pt, ')">">, font-size:10.5pt, Sucralfate">Sucralfatefont-size:10.5pt, ')">">, font-size:10.5pt, Retention enema')">">Retention enema

黄凤仙, 曹席明, 靳荣辉, 赵淑红, 刘屹. 硫糖铝保留灌肠预防宫颈癌患者急慢性放射性直肠损伤的临床观察[J]. 临床肿瘤学杂志, 2022, 27(03): 244-249.

HUANG Fengxian, CAO Ximing, JIN Ronghui, ZHAO Shuhong, LIU Yi.. Clinical observation of sucralfate retention enema on preventing acute and chronic radiation proctitis in patients with cervical cancer[J]. Chinese Clinical Oncology, 2022, 27(03): 244-249.

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