恶性肿瘤并发的抑郁症中医临床研究进展

抑郁症(depression)是由于各种原因引起的以抑郁为主要症状的一组心境障碍(mood disorders)或情感性障碍(affective disorders),是一组以抑郁心境自我体验为中心的临床症状群或状态.恶性肿瘤是严重威胁人类生命的疾病之一,尽管手术、放疗、化疗以及生物干预等对肿瘤的治疗取得很大进展,但肿瘤患者的心理问题尚未引起人们足够重视.国内外研究发现,恶性肿瘤的发生、发展与社会心理因素有着不可忽视的联系,患者并发抑郁症的比例较高[1-3],它严重影响患者的治疗与预后,使患者的生活质量下降[2].现把恶性肿瘤并发抑郁症的中医临床研究综述如下.

Purpose: To observe the effects of electroacupuncture therapy on T cells and activity of NK cell in the patient of Chemotherapy. Method: Electro-acupuncture therapy was simultaneously applied during chemotherapy, T cells and activity of NK cell of patients were determined before electroacupuncture treatment (before chemotherapy) and after 4-course electro-acupuncture treatments. Results: Before chemotherapy, CD3 was low within the normal range, CD4 was much lower than the normal range, and CD8, CD4/CD8 and activity of NK cell were within the normal range. After one month of chemotherapy combined with electro-acupuncture, no decline of all the indices was found (P>0.05). Conclusion: Electro-acupuncture can really increase the immune function of patients of chemotherapy.The suppression of both immunity and hematopoiesis caused by chemotherapy is mainly characterized by declines of T cells subpopulations (CD3, CD4, CD8), activity of NK cell, WBC count and humoral immunity. Since 1996, the authors have applied electro-acupuncture therapy for 28 cases of malignant tumor in the process of chemotherapy with good results as reported in the following.

体外膜肺氧合支持下经纤维支气管镜介入治疗重度恶性肿瘤性气道狭窄3例

肺癌、食管癌等常侵犯或压迫气管、支气管，严重气道狭窄甚至可直接导致窒息死亡。经支气管镜介入治疗已成为及时有效解除各种气道狭窄的首选治疗方法［1］，但对于严重气道狭窄患者，术中极有可能并发严重低氧血症、呼吸心搏骤停等，治疗往往受到限制［2］。国外有一些病例报道，体外膜肺氧合（ extracorporeal membrane oxygenation， ECMO）可用于小儿［3］及成人［4］严重气道狭窄时的支气管镜介入治疗，这种方式有效避免了术中低氧血症。本文报道了3例恶性肿瘤引起的严重气道狭窄患者，在ECMO支持下顺利完成经支气管镜介入治疗，及时解除气道梗阻。

胃肠外营养支持对晚期癌症病人营养和免疫恢复的促进作用

营养不良和进行性体重减轻是晚期肿瘤患者的普遍现象.胃肠外营养(PN)常被用来改善晚期癌症病人的营养状况和防止恶病质的进一步发展[1].对象和方法一、临床资料1997年11月～1999年5月,126例住院病人,均经临床确诊为晚期恶性肿瘤的住院病人.大多数为胃肠道肿瘤和肺癌患者,男性94例,女32例,大年龄83岁,小年龄25岁,平均年龄55.6±17.9岁.均作支持治疗或进行化疗,按均衡组原则分成肠外营养组(PN)及普通输液组(对照组),PN组64例,对照组62例.两组病例均无明显肝、肾、心功能损害,发病后体重变化少于原体重10%,无内分泌和代谢性疾病,研究过程中无明显感染征象.所有研究对象均由一组医护人员操作.

经典型骨肉瘤诊断与治疗路径

定义Conventional osteosarcoma is a primary intramedullary high grade malignant tumor in which the neoplastic cells produce osteoid, even if only in small amounts.

SDF-1/CXCR4生物轴与儿童恶性肿瘤的转移

基质细胞衍生因子1(stromal cell-derived factor-1,SDF-1,又名CXCL12)属于趋化因子中的CXC亚族,有同基因编码两种异构体SDF1α和SDF1β,其分子结构为N端两个半胱氨酸(CC)之间被另外一个氨基酸残基(X)所分隔.这种因子初是从骨髓基质细胞克隆,具有诱导前B细胞分化和增殖的作用.

儿童淋巴系恶性肿瘤合并股骨头坏死

近几十年来,急性淋巴细胞性白血病(ALL)和非霍奇金淋巴瘤(NHL)的预后得到了明显的改善,5年无病生存率已达到70%以上.随着预后的改善,影响远期生活质量的合并症越来越受到重视,如,与蒽环类抗肿瘤药物相关的心肌病、与铂类相关的肾小管功能不全、与放疗相关的局部组织发育不良和功能受损等一系列问题正在受到更多的关注.

Thirty pathological y diagnosed patients with grade III-IV primary or recurrent malignant glioma (tumor diameter 3-7 cm) were randomly divided into two groups. The control group underwent conventional radiotherapy and chemotherapy. In the hyperthermia group, primary cases received hyperthermia treatment, and patients with recurrent tumors were treated with hyperthermia in com-bination with radiotherapy and chemotherapy. Hyperthermia treatment was administered using a 13.56-MHz radio frequency hyperthermia device. Electrodes were inserted into the tumor with the aid of a CT-guided stereotactic apparatus and heat was applied for 1 hour. During 3 months after hyperthermia, patients were evaluated with head CT or MRI every month. Gliomas in the hyper-thermia group exhibited growth retardation or growth termination. Necrosis was evident in 80%of the heated tumor tissue and there was a decrease in tumor diameter. Our findings indicate that ra-dio frequency hyperthermia has a beneficial effect in the treatment of malignant glioma.

双膦酸盐治疗恶性肿瘤骨转移的研究进展

骨转移是恶性肿瘤常见并发症,很多实体瘤都有可能发生骨转移,并导致骨痛、高钙血症、病理性骨折和脊髓压迫等骨相关事件(skeletal-related events,SRE).

干扰素在血液系统恶性肿瘤的治疗价值

干扰素是50年代后期被发现的一种具有干扰病毒增殖活性的因子,现已证实干扰素至少存在着5种类型,即干扰素α,β,γ,δ,ω.干扰素具有多种生物学活性,能够调节细胞功能、病毒复制、细胞分化、生长抑制和免疫功能等.其中,对干扰素α的研究较多,它不仅具有抗病毒作用,而且还具有抗肿瘤和免疫调节作用.通过重组DNA技术生产出多种基因来源的重组干扰素α,为其广泛应用提供了可能性.本文将重点介绍干扰素α治疗血液系统恶性肿瘤的临床应用.

恶性肿瘤患者的日常护理

恶性肿瘤已成为威胁人类生命严重的疾病之一.恶性肿瘤是多种因素长期综合作用的结果,20世纪80年代末,世界卫生组织专家分析了大量的调查资料后指出恶性肿瘤实际上是一种生活方式的疾病,是不健康的生活方式长期积累形成的疾病[1].

自制体位套枕在恶性肿瘤病人化疗中的应用

随着医学模式的转变、现代护理学科的发展,护理工作不再是单纯的技术操作.更应注重"以人为本"的护理过程.早在1995年Kolcaba就提出了舒适护理的概念,舒适护理是整体护理的过程和追求,是在基础护理的基础上,使病人能获得更全面的舒适感和满意度.

恶性肿瘤组织标本的采集与保存

随着恶性肿瘤对人类的影响和危害性的增加,如何保护、保存并充分利用人类肿瘤遗传资源,提高我国肿瘤防治水平,已成为当务之急.作为恶性肿瘤研究材料的肿瘤组织标本在促进肿瘤研究进展过程中扮演了重要的角色,成为肿瘤研究工作的基础[1].我院是一所具有30余年历史的肿瘤诊断治疗与教学科研为一体的专科性医院,在苏北地区创建早、规模大,拥有得天独厚的标本资源.现将人体肿瘤组织标本的采集、保存、管理体会介绍如下.

赛肤润预防恶性肿瘤病人放射野皮肤发生压疮的临床观察与护理

放射治疗是恶性肿瘤的主要治疗手段之一.肿瘤本身是慢性消耗性疾病,机体营养状况差又是压疮的好发因素,而在放疗的同时放射野皮肤常常会发生损伤.皮肤的放射性损伤严重时会影响治疗,甚至会停止放疗,所以预防放疗病人放射野皮肤发生压疮是临床护理中需要重视的问题[1].因此,恶性肿瘤病人成为压疮的好发人群.本研究对接受放射治疗的病人使用赛肤润进行预防压疮的护理,效果明显.现报道如下.

125I植入治疗晚期恶性肿瘤的临床护理

目前,恶性肿瘤在国内仍是致死的首要因素,病人就诊时,中、晚期阶段病人较多,降低了手术治疗的机会,瘤体侵犯重要脏器影响肿瘤的切除,怕的是"转移癌","转移癌"的出现就是癌症晚期的到来,转移灶在一个脏器内有两个以上,治疗极为棘手,应用"粒子刀"粒子植入到体内,有助于瘤体的整体杀灭,不降低脏器的生理功能,减少了组织创伤及组织并发症,提高了病人的生存率[1].了解晚期癌症病人粒子植入术的方法,并采取积极有效地护理措施,以提高晚期癌症病人的生存质量.现将护理介绍如下.

恶性肿瘤病人围手术期抑郁焦虑影响因素分析

恶性肿瘤发病率逐年上升,已成为威胁人们生命,影响人们生活质量的常见病和多发病.研究表明;癌症病人的情绪异常对预后影响极大[1].不良的情绪往往导致病人的生活质量下降,影响治疗的效果[2].本研究就恶性肿瘤病人围手术期抑郁焦虑状态及相关因素的分析结果报告如下.

树突状细胞疫苗治疗恶性肿瘤的疗效观察与护理

肿瘤免疫治疗是目前肿瘤治疗领域中的研究热点之一,其主要通过调节或增强机体固有的防御体系来抑制或杀伤肿瘤细胞,或通过抑制肿瘤细胞转化、促进恶性细胞分化来降低肿瘤的恶性程度[1].

晚期恶性肿瘤125I放射性粒子植入术的护理配合

随着计算机技术的广泛应用及超声和CT影像学技术的进展,近距离放射治疗得到了较快发展,配合术中直视进行放射性粒子组织间插植治疗,对提高癌症病人的生存率和降低局部复发率、改善生存质量有良好效果.<'125>I放射粒子的问世,促进了国内组织间放射性粒子植入治疗的发展<'[1]>.我院2005年1月-2007年5月采用肿瘤术中<'125>I种子源组织间永久性植入治疗9例各种晚期恶性肿瘤病人,取得了满意的效果.

恶性肿瘤病人PICC致血栓相关因素分析及护理

近年来,经外周置入中心静脉导管(PICC)在肿瘤科化疗中广泛应用,避免了病人反复外周静脉穿刺的痛苦,一次穿刺成功率高,并发症低,留置时间长且安全,在一定程度上提高了病人治疗的耐受性.尽管PICC优点很多,但是并发症也频频发生,尤其是微血栓的形成,给病人造成很大负担.为了分析血栓形成的相关因素,笔者于2006年1月-2007年12月对行PICC的86例恶性肿瘤病人进行临床观察,研究性别、年龄、导管型号、肿瘤类型、凝血指标测定[凝血酶原时间(PT)、活化部分凝血时间(APTT)、纤维蛋白原(FIB)]及D-二聚体测定与血栓形成有无相关性.

康复期癌症人的心理问题探讨

Background: The mental problems of the patients with malignant tumor are complex, and it is very important for rehabilitation of the patients to find the most common and prominent mental problems and perform effective mental care. Objective: To discuss the mental problems of the patients with malignant tumor in the recovery stage. Unit: the tumor department of Hospital of Heze City in Shandong Province. Subject: All cases in the research came from the patients with malignant tumor in our hospital durng the period of 1998～ 2000. We selected 100 cases who have reached fully clinical recovery or turned better and could take care of oneself by systemic therapy. In the group, there were 61 males and 39 females; 30 patients in 40～ 55 years old, 70 in 56～ 65; 39 cases who were illiterate, 36 who only accepted primary school education, 21 who accepted middle school education, 4 who reached the degree of university education; 63 farmers, 28 workers, 4 cadres, and 5 individual businessman. Intervention: During the days before leaving hospital, record the mental problems worried most of the patients by responsibility nurse' survey. In the course, only record whether there were the problems or not and the content of the problems, but never determine the degree of the problems. Result:(1) The problems most worried by 27 patients were there were no effective therapeutic methods (27％ ); (2) The problems most worried by 21 patients were the life would be terminal (21％ ); (3) The problems most worried by 12 patients were short of family income, decrease of labor ability and arrangement of the children (12％ ); (4) The problems most worried by 6 patients were unhappy relationship between man and wife (6％ ); (5) The problems most worried by 15 patients were parents or children would be encumbered (15％ ); (6) The problems most worried by 9 patients were radiological or chemical therapy would not be performed regularly (9％ ); (7) There were 10 patients who had no the special problems most worried (10％ ). By statistical analysis, there was obvious difference in sex between (2) and (3) (P< 0.01). The female worried (2) problems were more than the male, while the male worried (3) problems were more than the female. In addition by statistical disposal, we found the problems most worried were relative with sex,age,educational degree,job of the patients (P >0.05); and obviously relative with the progressive degree of tumor (P< 0.01), because the mental problems of the patients with early stage tumor were less than the patients with late stage tumor obviously. Conclusion: The mental problems of the patients with malignant tumor in the recovery stage should be paid attention to, and it's significant for rehabilitation of the patients to apply effective mental care.