肠道水化与静脉水化对顺铂治疗妇科恶性肿瘤肾毒性影响的比较  

Comparison of Intestinal and Intravenous Hydration Effects on Nephrotoxicity in Cisplatin-Based Chemotherapy for Gynecologic Malignant Tumor

作　　者：严婷[1] 周遵伦[2] 黄林[2] 矫洁[2] 

机构地区：[1]贵州省人民医院,贵州贵阳550002 [2]贵阳医学院附属医院,贵州贵阳550004

出　　处：《实用妇产科杂志》2008年第8期475-478,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨改良肠道水化与静脉水化对顺铂治疗妇科恶性肿瘤肾毒性的影响。方法:将66例经病理证实为妇科恶性肿瘤(卵巢癌48例,子宫内膜癌10例,宫颈癌6例,子宫肉瘤2例),以顺铂为主进行联合化疗的患者随机分组:静脉水化组,即第1天的静脉输液量不少于2500 ml/m2,并连用3天。肠道水化组,即每天的输液量少于2500 ml/m2。根据补液量的多少,将肠道水化组再次分为两组:组①,即每天的输液量少于2500 ml/m2,但不少于1000 ml/m2;组②,每天的输液量少于1000 ml/m2。分别在使用顺铂治疗前和治疗后第3天留尿测尿的β2-微球蛋白(β2-MG)浓度。结果:将静脉水化组和肠道水化组患者化疗前后尿β2-MG浓度作成组设计两样本差值比较的秩和检验,差异无统计学意义(P>0.05);肠道水化组①和组②亦进行成组设计两样本差值比较的秩和检验,差异无统计学意义(P>0.05)。结论:在保证患者尿量充足的情况下,采用静脉水化与改良肠道水化对肾毒性的影响无明显差异;在改良肠道水化时,使用输液量多少也无明显影响。可见肠道水化方案也能较好地预防顺铂的肾毒性。Objective： To investigate the effect of reformed intestinal and intravenous hydration therapy on nephrotoxicity in patients with gynecologic malignant tumor receiving Cisplatin-based combination chemotherapy. Methods： 66 patients with gynecologic malignant tumor were treated with Cisplatin-based combination chemotherapy and divided into 2 groups randomly： intravenous hydration group and intestinal hydration group. Intravenous hydration group were transfused no less than 2500ml/m^2 every day. Intestinal hydration group were transfused less than 2500ml/m^2 every day. According to the volume of transfusion, the intestinal hydration group was divided into two subgroups again. The 1st group was transfused 1000 - 2500ml/m^2 every day, and the 2nd group less than 1000ml/m^2 every day. The concentration of/32-MG in urine was detected before and the 3rd day after using Cisplatin. Results： To compare urine concentration of β2-MG of intravenous hydration and intestinal hydration, there was no significant difference（P〉0.05）, there was also no significant difference between the 1st and 2nd group（ P〉 0.05）. Conclusions： Under the condition of guaranteeing the uric volume, there is no significant different effect on nephrotoxicity of CisplaUn of the two methods. And we found the therapy of intestinal hydration could also prevent nephrotoxicity of Cisplatin.

关 键 词：妇科肿瘤 化疗 顺铂 肾毒性 水化 

分 类 号：R737.3[医药卫生—肿瘤]