| 盖龙娴,武 霞.湿润烧伤膏联合龙血竭防治乳腺癌改良根治术后放射性皮肤损伤疗效观察[J].中国烧伤创疡杂志,2020,(3):202~206. |
| DOI： |
| 中文关键词: 湿润烧伤膏 龙血竭 乳腺癌 放射治疗 放射性皮肤损伤 |
| 英文关键词:MEBO Dragon’s blood Breast cancer Radiotherapy Radiation-induced skin injury |
| 基金项目:临沂市科技发展计划项目 |
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| 中文摘要: |
| 目的 对比分析湿润烧伤膏联合龙血竭防治乳腺癌改良根治术后放射性皮肤损伤的临床疗效。方法 将2015年8月至2018年8月临沂市第三人民医院收治的120例乳腺癌改良根治术后行放射治疗的患者按照治疗方法分为观察组（60例）、对照1组（30例）与对照2组（30例），观察组患者放射治疗后照射区域皮肤均匀涂抹湿润烧伤膏，出现Ⅱ～Ⅳ级放射性皮肤损伤时加用龙血竭粉末外敷；对照1组患者放射治疗后照射区域皮肤均匀涂抹湿润烧伤膏，出现Ⅱ～Ⅳ级放射性皮肤损伤时继续应用湿润烧伤膏换药治疗；对照2组患者放射治疗后照射区域皮肤不采取防护措施，出现Ⅱ～Ⅳ级放射性皮肤损伤时予以碘伏常规换药治疗。对比观察3组患者放射性皮肤损伤发生情况、放射治疗中断情况及临床疗效。结果 放射治疗20 Gy、40 Gy及结束后，3组患者皮肤损伤发生情况对比，χ2=59.417、94.876、29.072，P均=0.000，差异具有统计学意义，且对照2组患者皮肤损伤发生情况均明显差于观察组及对照1组（放射治疗20 Gy后：χ2=41.918、23.721，P均=0.000；放射治疗40 Gy后：χ2=74.118、47.368，P均=0.000；放射治疗结束后：χ2=61.606、30.610，P均=0.000），而观察组与对照1组患者皮肤损伤发生情况无明显差异（P均＞0.05）。放射治疗过程中，对照2组中有7例患者因放射性皮肤损伤中断治疗，明显高于观察组与对照1组均无患者中断治疗（χ2=15.181、7.925，P=0.000、0.005）。放射治疗结束后2周，观察组患者的临床疗效明显优于对照1组及对照2组（χ2=6.923、24.761，P=0.009、0.000），而对照1组患者的临床疗效明显优于对照2组（χ2=8.324，P=0.016）。结论 湿润烧伤膏联合龙血竭可有效防治乳腺癌改良根治术后放射性皮肤损伤，促进放射性皮肤损伤创面愈合，且操作简便，值得临床推广应用。 |
| 英文摘要: |
| 【Abstract】 To comparatively analyze the therapeutic effect of MEBO combined with dragon’s blood in the prevention and treatment of radiation-induced skin injury after modified radical mastectomy for breast cancer. Methods One hundred twenty patients who underwent radiotherapy after modified radical mastectomy for breast cancer, admitted to The People’s Hospital of Linyi Ecnomic Development Area from August 2015 to August 2018 were divided, according to their treatment, into observation group (60 cases), control group 1 (30 cases) and control group 2 (30 cases). Radiation area skin of patients after radiotherapy in the observation group was evenly applied with MEBO and dragon’s blood was smeared when grade Ⅱ ～ Ⅳ radiation skin damage was observed; radiation area skin of patients after radiotherapy in the control group 1 was evenly applied with MEBO, and MEBO therapy continued when grade Ⅱ ～ Ⅳ radiation skin damage was observed; no protective measure was adopted for radiation area skin of patients after radiotherapy in control group 2 and routine dressing change with iodophor was performed when grade Ⅱ ～ Ⅳ radiation skin damage was observed. The radiation-induced skin injuries, the interruption of radiotherapy, and the therapeutic effect of the three groups were compared and observed. Results At the dose of 20 Gy, 40 Gy and at the end of radiotherapy, the skin injuries of patients in the three groups was compared (χ2 = 59.417, 94.876, 29.072, all P = 0.000) and the results showed statistically significant difference, and the skin injuries of patients in control group 2 were significantly worse than the observation group and control group 1 (at the dose of 20 Gy of radiotherapy: χ2 = 41.918, 23.721, all P = 0.000; at the dose of 40 Gy of radiotherapy: χ2 = 74.118, 47.368, all P = 0.000; at the endo of therapy: χ2 = 61.606, 30.610, all P = 0.000), and no significant difference in skin injuries was observed between the observation group and the control group 1 (all P> 0.05). During the radiotherapy, the treatment of 7 patients in the control group 2 was discontinued due to radiation-induced skin injuries and the number was significantly more than the observation group and the control group 1 (χ2 = 15.181, 7.925, all P = 0.000, 0.005). Two weeks after the radiotherapy, the therapeutic effect of the observation group was significantly better than control group 1 and control group 2 (χ2 = 6.923, 24.761, P = 0.009, 0.000) and the therapeutic effect of control group 1 was significantly better than control group 2 (χ2 = 8.324, P = 0.016). Conclusion MEBO combined with dragon’s blood can prevent and treat radiation-induced skin injuries after modified radical mastectomy for breast cancer, and promote wound healing of the radiation-induced skin damage. It is easy to use and deserves to be promoted in clinical application. |
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