目的 观察卡培他滨联合顺铂治疗老年胆囊癌的临床疗效.方法 选取2009年1月—2014年10月平顶山市第二人民医院收治的老年胆囊癌患者80例,随机分为对照组和治疗组,每组40例.对照组分别于每个化疗疗程的第1、8天静脉输注注射用顺铂25 mg/m².治疗组于每个化疗疗程的第1～14天口服卡培他滨片1.5 g/m²,2次/d,注射用顺铂的用法用量同对照组.两组3周为1个疗程,共治疗2个疗程.治疗结束后比较两组的临床疗效,观察两组治疗前后部分临床症状改善和不良反应发生情况.结果 治疗后,对照组和治疗组的总有效率分别为36.84%、65.00%,两组比较差异有统计学意义(P< 0.05).两组患者治疗后,恶心、呕吐均得到改善,对照组和治疗组恶心的改善率分别为57.89%、95.00%,两组患者呕吐的改善率分别为57.89%、95.00%,治疗组症状改善率显著高于对照组,两组比较差异有统计学意义(P< 0.05).治疗过程中两组均可发生白细胞下降、血红蛋白下降、血小板下降、肝肾功能受损、恶心呕吐不良反应,但是治疗组的不良反应发生率明显低于对照组,两组比较差异有统计学意义(P< 0.05).结论 卡培他滨联合顺铂治疗胆囊癌临床疗效确切,患者症状改善明显,不良反应较轻,值得临床推广应用.

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.