CAJ | 학술논문

目的观察多药联合预防肺癌术后辅助化疗中恶心、呕吐的临床效果.方法肺癌术后接受多西他赛+顺铂辅助化疗患者115例,随机分为两组,对照组58例,止吐方案为化疗前半小时静脉注射阿扎司琼10 mg/次,第1～5天；静脉注射地塞米松10 mg/次,第1～3天.治疗组57例,在对照基础上加用异丙嗪25 mg/次、甲氧氯普胺10 mg/次,化疗前半小时肌肉注射,第1～5天；奥美拉唑40mg/次,化疗前45 min静脉滴注,第1～5天.观察两种方案对预防急性、迟发性恶心、呕吐的效果.结果治疗组与对照组预防急性恶心、呕吐的总有效率差异均无统计学意义(P均＞0.05),预防迟发性恶心第2、3、4、5天的总有效率差异均有统计学意义[分别为87.7％ (50/57)与72.4％( 42/58),x2=4.21;84.2％( 48/57)与67.2％ (39/58),x2 =4.49;91.2％ (52/57)与77.6％( 45/58),x2=4.05; 94.7％( 54/57)与81.0％(47/58),x2=5.04；P均＜0.05],预防迟发性呕吐第2、3、4、5天的总有效率差异均有统计学意义[分别为91.2％( 52/57)与74.1％( 43/58),x2=5.84;91.2％ (52/57)与70.7％(41/58),x2=7.84;94.7％ (54/57)与79.3％ (46/58),x2 =6.03;98.2％ (56/57)与87.9％ (50/58),x2=5.77;P均＜0.05].两组发生的不良反应主要为头晕、头痛、便秘等,组间不良反应发生率[ 15.8％ (9/57)与20.7％(12/58)]差异无统计学意义(x2=0.46,P=0.49).结论多药联合可显著降低肺癌术后辅助化疗中恶心、呕吐的发生率,特别是对迟发性恶心、呕吐有更好的预防作用.
목적 관찰다약연합예방폐암술후보조화료중악심、구토적림상효과.방법 폐암술후접수다서타새+순박보조화료환자115례,수궤분위량조,대조조58례,지토방안위화료전반소시정맥주사아찰사경10 mg/차,제1～5천；정맥주사지새미송10 mg/차,제1～3천.치료조57례,재대조기출상가용이병진25 mg/차、갑양록보알10 mg/차,화료전반소시기육주사,제1～5천；오미랍서40mg/차,화료전45 min정맥적주,제1～5천.관찰량충방안대예방급성、지발성악심、구토적효과.결과 치료조여대조조예방급성악심、구토적총유효솔차이균무통계학의의(P균＞0.05),예방지발성악심제2、3、4、5천적총유효솔차이균유통계학의의[분별위87.7％ (50/57)여72.4％( 42/58),x2=4.21;84.2％( 48/57)여67.2％ (39/58),x2 =4.49;91.2％ (52/57)여77.6％( 45/58),x2=4.05; 94.7％( 54/57)여81.0％(47/58),x2=5.04；P균＜0.05],예방지발성구토제2、3、4、5천적총유효솔차이균유통계학의의[분별위91.2％( 52/57)여74.1％( 43/58),x2=5.84;91.2％ (52/57)여70.7％(41/58),x2=7.84;94.7％ (54/57)여79.3％ (46/58),x2 =6.03;98.2％ (56/57)여87.9％ (50/58),x2=5.77;P균＜0.05].량조발생적불량반응주요위두훈、두통、편비등,조간불량반응발생솔[ 15.8％ (9/57)여20.7％(12/58)]차이무통계학의의(x2=0.46,P=0.49).결론 다약연합가현저강저폐암술후보조화료중악심、구토적발생솔,특별시대지발성악심、구토유경호적예방작용.
Objective To observe the clinical effect of the combined medication to prevent postoperative adjuvant chemotherapy-related nausea and vomiting after lung cancer surgery.Methods One hundred and fifteen patients under cisplatin-based chemotherapy were randomly divided into the control group ( n =58 ) and the treatment group( n =57 ).For the control group,Azasetron ( day 1-5 ) and dexamethasonewere (day 1-3 )were injected intravenously with a dose of 10 mg/day at half an hour before chemotherapy.For the treatment group,intramuscular injection of promethazine (25 mg/day,30 mins before surgery ) and metoclopramide( 10 mg/day,30 mins before surgery )and intravenous infusion of omeprazole (40 mg/day,45 mins before surgery)were given from day 1 to day 5 in addition to the treatment for the control group to relieve chemotherapy-induced acute and late-phased nausea and vomiting.Results There were no significant differences between the two groups in controlling acute nausea and vomiting in terms of complete response rate (Ps ＞0.05 ).However,there were significant effect on late-phased nausea,with an effective rate of 87.7％(50/57) in the treatment group versus 72.4％ (42/58) in the control group at day 2 after treatment( x2 =4.21,P ＜ 0.05 ),and 84.2％ (48/57) vs.67.2％ ( 39/58 ) at day 3 ( x2 =4.49,P ＜ 0.05 ),91.2％ ( 52/57 ) vs.77.6％ (45/58) at day 4 ( x2 =4.05,P ＜ 0.05 ),94.7％ ( 54/57 ) vs.81.0％ ( 47/58 ) at day 5 ( x2 =5.04,P ＜ 0.05 ).Furthermore,there were significant effect on late-phased vomiting,with an effective rate of 91.2％ (52/57)in the treatment group versus 74.1％ (43/58) in the control group at day 2 after treatment ( x2 =5.84,P ＜ 0.05 ),and 91.2％ ( 52/57 ) vs.70.7％ ( 41/58 ) at day 3 ( x2 =7.84,P ＜ 0.05 ),94.7％ ( 54/57 ) vs.79.3％ ( 46/58 ) at day 4 ( x2 =6.03,P ＜ 0.05 ),98.2％ (56/57) vs.87.9％ (50/58) at day 5 ( x2 =5.77,P ＜ 0.05 ).The common side effect in both group were dizzy,headache and coporostasis,with no significant difference [ 15.8％ ( 9/57 )vs.20.7％(12/58),x2 =0.46,P=0.49 ].Conclusion The combinational medication used in the treatment group prominently reduced the incidence of chemotherapy-induced nausea and vomiting after pneumonectomy,especially the late-phased nausea and vomiting.