综合治疗方案在中晚期宫颈癌中的应用

观察综合方案治疗中晚期宫颈癌的近远期疗效,探索这一治疗方案在中晚期宫颈癌治疗中的应用价值。     

中医辨证配合化疗治疗晚期肺癌临床分析

目的探究中医辨证配合化疗对晚期肺癌患者的临床治疗效果。方法将我院2011年1月～2012年1月接诊的53例晚期肺癌患者作为研究对象,随机分为研究组与对照组。对照组患者单纯采用化疗治疗,研究组则在对照组的基础上配合中医辨证治疗。对两组病患的治疗效果进行总结与对比。结果研究组治疗前平均分为58.45分,治疗后为71.35分,对照组治疗前平均分为58.13分,治疗后为49.63分;研究组27例患者半年的生存率为81.48%,一年的生存率为48.15%,对照组26例患者半年生存率为46.15%,一年生存率为15.38%;治疗效果上,研究组总有效率为40.74%,对照组总有效率为15.38%。结论对于晚期肺癌患者而言,采用中医辨证配合西医化疗治疗,除了可以提高患者对化疗的耐受性之外,还能明显提高患者的生存质量,当属一种值得临床推广及应用的治疗方法。     

乳腺癌术后患侧上肢PICC置管化疗的临床应用

目的探讨PICC在乳腺癌患者患侧上肢临床使用效果。方法确定健侧上肢无法置管,患侧上肢无肿胀,术中只结扎腋静脉的分支,对腋静脉没有影响的25例患者,实施患侧上肢PICC置管,置管后做好肢体及导管护理。结果 25例患侧置管患者,14例在贵要静脉置管,11例肘正中静脉置管,胸片显示：管尖端均进入上腔静脉中下端,留置时间为126～168d,6～8疗程。贵要静脉发生穿刺口感染1例,肘正中静脉发生静脉炎4例,经处理后症状改善,全部顺利完成化疗,无严重并发症发生,顺利拔管。结论正确评价患侧上肢血管,严格规范置管和导管维护,重视对患者宣教,乳腺癌患者患侧上肢可行PICC置管。     

Cost-effectiveness analysis of utidelone plus capecitabine for metastatic breast cancer in China

Abstract

Objective: To estimate the cost-effectiveness of utidelone plus capecitabine therapy compared to capecitabine alone in patients with metastatic breast cancer (MBC) resistant to anthracyclines and taxanes treatment in the Chinese context and provide a reference for the marketing of utidelone in China.

Methods: A Markov model was developed based on the NCT02253459 clinical trial to simulate the clinical course of patients with metastatic breast cancer who had received taxanes and anthracycline therapy. The quality-adjusted life years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) were then analyzed to evaluate the benefits. Two-parametric Weibull distribution was conducted to fit PFS and OS curves by using R. Sensitivity analyses were performed to evaluate the stability of the model designed.

Results: The addition of utidelone increased the cost and QALYs by $13,370.25 and 0.1961, respectively, resulting in an increased ICER of $68,180.78 per QALY. The most sensitive influential parameter on ICER was the price of utidelone. At the threshold of willingness-to-pay (WTP) of $24,380 (3 per capita GDP of China), the cost of utidelone per 30?mg of less than $18.5, $33.7, and greater than $48.8 resulted in a 100%, 50%, and 0% possibility of cost-effectiveness, respectively. The addition of utidelone was not cost-effective when it was $115.4 per 30?mg—the price of its analog paclitaxel. In consideration of varied economics levels across China, cost-effectiveness could be achieved with the price of utidelone ranging from $5.2 to $35.9.

Limitations: The survival curves extended beyond the follow-up time horizon, of which data were generated not from the real analyses but from our established two-parameter Weibull survival model.

Conclusion: It is recommended that the price of utidelone would be less than $18.5 per 30?mg in order to obtain cost-effectiveness for metastatic breast cancer patients resistant to anthracyclines and taxanes treatment in China.     

浅谈单侧多中心性乳腺癌分析

目的:探讨单侧多中心性乳腺癌的特点及治疗方法。病灶多分布在同一象限或相邻象限,以浸润性导管癌为主,采用乳腺癌改良根治为主的综合治疗。     

论胶原蛋白对人类健康的特殊作用

胶原蛋白在人体中含量很多,过去一直被人们视为非常普通的物质而未加留意和重视。二十世纪七十年代以来,国际上对于胶原蛋白的研究相当活跃,取得了惊人的进展。现已发现,胶原蛋白具有提高免疫力、预防癌症、防治慢性病、促进细胞新陈代谢、提高钙的吸收力、消除便秘等功能,与人类健康不但息息相关,且具有非常重要的作用。     

88例食道癌术后胃肠减压的护理干预

目的:探讨食道癌术后胃肠减压的护理。方法:对88例食道癌术后患者胃肠减压期间,给予心理护理等一系列的护理措施。结果:所有患者中85例置管成功,有3例没有成功,成功率为96%,有2例出现了脱落,有1例出现了自行拔出胃管。结论:对患者进行有效的胃肠减压,这是确保手术成功的必要条件,护理工作中要密切观察患者的引流是否通畅,如发现问题要及时进行调整,使患者快捷痊愈。     

晚期乳腺癌患者的临床治疗及其护理效果

目的探讨晚期乳腺癌患者的临床治疗及其护理效果。方法选取我院近年收治的晚期乳腺癌患者共52例,采用药物治疗、手术治疗、内分泌治疗,并采取针对性护理干预,比较患者的术后并发症情况。结果患者并发症发生率达到34.6%,其中以皮下积液为主,另存在术侧上肢水肿以及皮瓣坏死2类并发症。所有患者术后经过护理干预后均痊愈而顺利出院。结论对晚期乳腺癌患者的临床治疗可多元化,临床护理也应从多角度展开,注重并发症的预防及护理干预,提升治疗的有效性。     

大肠癌结肠镜检查与分析

目的探讨结肠镜检查大肠癌患者的发病情况及发病率。方法本组资料源于我院2013年1月至2014年6月结肠镜检查并经病理活检确诊的58例大肠癌患者。所有受检者均在电子结肠镜下观察,对有溃疡、肿块、糜烂、狭窄等肿瘤病灶部位取活检行病理诊断,明确组织类型。结果 58例大肠癌患者就诊时主要症状腹痛15例,肉眼血便10例,腹泻3例,腹部包块2例,贫血1例;所有患者粪便潜血实验阳性46例;直肠39例,左半结肠9例,右半结肠10例;溃疡型22例,肿块型27例,浸润型9例;腺癌56例,黏液腺癌2例。结论兴山县大肠癌肠镜检出率相对较高,发病部位以直肠为主,本地区应大力开展大肠癌早期诊断、早期治疗工作。     

宫颈癌新辅助化疗的临床疗效

目的探讨宫颈癌术前应用新辅助化疗的临床疗效。方法 68例宫颈癌术前采用2个疗程的新辅助化疗后进行手术,观察近期疗效。结果 68例患者化疗2个疗程后的临床总有效率为70.1%。经过术前辅助化疗后,进行广泛性子宫切除加盆腔淋巴结清扫手术,全部患者均顺利切除病灶。结论术前新辅助化疗对宫颈癌Ⅰb1~Ⅱb期患者治疗安全有效,可缩小肿瘤体积,提高手术切除率及疗效,进一步改善患者的生活质量。