目的 觀察卡培他濱聯(lián)合順鉑治療老年膽囊癌的臨床療效.方法 選取2009年1月—2014年10月平頂山市第二人民醫(yī)院收治的老年膽囊癌患者80例,隨機分為對照組和治療組,每組40例.對照組分別于每個化療療程的第1、8天靜脈輸注注射用順鉑25 mg/m².治療組于每個化療療程的第1～14天口服卡培他濱片1.5 g/m²,2次/d,注射用順鉑的用法用量同對照組.兩組3周為1個療程,共治療2個療程.治療結(jié)束后比較兩組的臨床療效,觀察兩組治療前后部分臨床癥狀改善和不良反應(yīng)發(fā)生情況.結(jié)果 治療后,對照組和治療組的總有效率分別為36.84%、65.00%,兩組比較差異有統(tǒng)計學(xué)意義(P< 0.05).兩組患者治療后,惡心、嘔吐均得到改善,對照組和治療組惡心的改善率分別為57.89%、95.00%,兩組患者嘔吐的改善率分別為57.89%、95.00%,治療組癥狀改善率顯著高于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P< 0.05).治療過程中兩組均可發(fā)生白細(xì)胞下降、血紅蛋白下降、血小板下降、肝腎功能受損、惡心嘔吐不良反應(yīng),但是治療組的不良反應(yīng)發(fā)生率明顯低于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P< 0.05).結(jié)論 卡培他濱聯(lián)合順鉑治療膽囊癌臨床療效確切,患者癥狀改善明顯,不良反應(yīng)較輕,值得臨床推廣應(yīng)用.

Objective To evaluate the clinical efficacy of capecitabine combined with cisplatin in treatment of elderly gallbladder. Methods The patients with elderly gallbladder (80 cases) of Pingdingshan the Second People's Hospital from January 2009 to October 2014 were randomly divided into control and treatment groups, and each group had 40 cases. The patients in the control group were iv administered with Cisplatin for injection 25 mg/m² on the first and eighth day of each chemotherapy cycle. The patients in the treatment group were po administered with Capecitabine Tablets, 1.5 g/m², twice daily, and the usage and dosage of Cisplatin for injection were the same as the control group. One course of treatment was 21 d, and two groups were treated for two courses of chemotherapy. After treatment, the efficacy was evaluated, and improved situation of clinical symptoms and adverse reactions in two groups were observed. Results After treatment, the total effective rate of control and treatment groups were 36.84% and 65.00%, respectively, and there were differences between two groups (P <0.05). After treatment, nausea and vomiting in two groups were improved, and improvement rates of nausea in control and treatment groups were 57.89% and 95.00%, respectively, while improvement rates of vomiting were 57.89% and 95.00%. The improvement rates of symptoms in treatment group were significantly higher than those in the control group, and there were differences between two groups (P <0.05). Adverse reactions such as white blood cells, hemoglobin, and platelets reduced, liver and kidney function damaged, nausea, and vomiting could happen in the process of leucocyte in two groups, and the incidences of adverse reaction were significantly lower than those in the control group (P <0.05). Conclusion Capecitabine combined with cisplatin has clinical curative effect in treatment of elderly gallbladder, and symptoms of patients improved obviously with less adverse reaction, which is worth clinical popularization and application.