实用医学杂志 ›› 2022, Vol. 38 ›› Issue (15): 1884-1889.doi: 10.3969/j.issn.1006⁃5725.2022.15.007

• 专题报道 • 上一篇    下一篇

高压氧联合奥拉西坦治疗宫颈癌患者化疗相关认知障碍的疗效 

胡琴 王静依    

  1. 成都医学院附属第二医院核工业四一六医院妇科(成都 610000)

  • 出版日期:2022-08-10 发布日期:2022-08-10
  • 通讯作者: 王静依 E⁃mail:wjy416h@163.com
  • 基金资助:
    四川省卫生健康委员会 2019 年科研课题(编号:19PJ211);成都市卫生健康委员会 2021 年科研课题(编号:2021226)

The efficacy of hyperbaric oxygen combined with oxiracetam for chemotherapy ⁃related cognitive impair⁃ ment in patients with cervical cancer

HU Qin,WANG Jingyi.   

  1. Department of Gynaecology416 Hospital of nuclear industrythe Second Affiliated Hospital of Chengdu Medical CollegeChengdu 610000China
  • Online:2022-08-10 Published:2022-08-10
  • Contact: WANG Jingyi E⁃mail:wjy416h@163.com

摘要:

目的 观察高压氧联合奥拉西坦治疗宫颈癌患者化疗相关认知障碍(chemotherapy⁃related cognitive impairment,CRCI)的疗效。方法 选择2019年2月至2021年7月在本院收治的宫颈癌CRCI患者, 随机分为高压氧组和对照组。对照组采用奥拉西坦并吸入高压空气作为安慰治疗。高压氧组采用奥拉西 +高压氧治疗。观察两组治疗前、治疗结束以及结束后1个月和3个月的霍普金斯词汇学习测验-修订版 HVLT)和连线测验(TMT);扫描两组治疗前后的磁共振弥散张量成像(DTI),采集两组治疗前后的相 关实验室指标结果 在不同时间节点两组 HVLT TMT 方面,高压氧组在治疗 4 周、治疗结束 1 个月和 3个月的HVLT总分以及在治疗结束1个月和治疗结束3个月的TMT总时长优于对照组(P < 0.05)。在 DTI 方面,高压氧组在右侧矢状层、双侧扣带束、双侧下额枕束、左侧上纵束以及胼胝体压部的 FA 高于 照组(P < 0.05)。高压氧组在相关实验室指标 NSE、GFAP、BDNF 水平均优于对照组(P < 0.05)。 结论 高压氧联合奥拉西坦治疗宫颈癌CRCI,能有效改善其认知障碍、影像学指标和实验室指标,其近远 期疗效显著。

关键词:

高压氧, 奥拉西坦, 宫颈癌, 化疗相关认知障碍, 磁共振弥散张量成像

Abstract:

Objective To observe the efficacy of hyperbaric oxygen combined with oxiracetam in the treatment of chemotherapy ⁃ related cognitive impairment(CRCI)in patients with cervical cancer. Methods The patients with CRCI treated in our hospital from February 2019 to July 2021 were randomly assigned to a hyperbaric oxygen group or a control group. The control group received oxiracetam and inhalation of high⁃pressure air as placebo whereas the hyperbaric oxygen group received oxiracetam plus hyperbaric oxygen. The Hopkins Verbal Learning Test ⁃Revised(HVLT ⁃R)and the Trail Making Test(TMT)were observed before,at the moment of treatment completion,and months 1 and 3 after treatment;MRI diffusion tensor imaging(DTI)was performed before and after treatment,the relevant laboratory indexes were collected before and after treatment in both groups. Results In the aspect of HVLT and TMT at different time points,the total HVLT score was higher and the total length of TMT was better in the hyperbaric oxygen group than in the control group at week 4 after treatment months 1 and 3 after treatment completion(P < 0.05). In terms of DTI,the FA values in the right sagittal stratum bilateral cingulum,inferior fronto⁃occipital fasciculus,left superior longitudinal fasciculus,and splenium of corpus callosum were higher in the hyperbaric oxygen group than in the control group(P < 0.05). For related laboratory indexes,levels of NSE,GFAP,and BDNF in the hyperbaric oxygen group were superior to those in the control group(P < 0.05). Conclusions Hyperbaric oxygen combined with oxiracetam for CRCI in patients with cervical cancer can effectively improve cognitive impairment and imaging and laboratory indexes,showing a marked short⁃ and long⁃term efficacy.

Key words:

hyperbaric oxygen, oxiracetam, cervical cancer, chemotherapy?related cognitive impair? ment, diffusion tensor imaging