奥氮平预防化疗所致爆发性呕吐的临床观察  

Clinical observation of olanzapine in prevention of explosive chemotherapy-induced vomiting in patients with cancer

作　　者：庞红霞[1] 郑伟生[1] 柯秋晴[1] 洪燕妮[1] 洪雅萍[1] 

机构地区：[1]福建医科大学附属泉州第一医院肿瘤内科,福建泉州362000

出　　处：《临床肿瘤学杂志》2014年第4期334-337,共4页Chinese Clinical Oncology

摘　　要：目的：探讨奥氮平预防化疗所致爆发性呕吐的疗效与安全性。方法收集2012年7月至2013年6月在化疗第1周期发生爆发性呕吐的36例恶性肿瘤患者，于第2周期化疗前给予常规预防止吐及口服奥氮平（奥氮平10mg/次，每日1次，d1～d3）预防爆发性呕吐，采用CTCAE标准对呕吐程度进行评分，比较联合奥氮平预防前后患者恶心呕吐评分的差异。结果36例患者联合奥氮平预防后恶心呕吐评分较联合前明显下降（10.1±0.9 vs．18.2±1.2，P＝0.032），其中47.2％（17/36）患者未再发生呕吐，75.0％（9/12）的女性患者未再出现爆发性呕吐。36例恶性肿瘤患者采用奥氮平治疗的止吐有效率为80.0％。主要相关毒副反应为头晕和乏力，发生率分别为36.1％和30．6％。结论奥氮平能有效降低化疗相关爆发性呕吐的发生率，改善恶性肿瘤患者化疗后的恶心呕吐。Objective To evaluate the efficacy and safety of olanzapine in prevention of breakthrough chemotherapy-induced vomiting in cancer patients receiving highly emetogenic chemotherapy. Methods Thirty-six cancer patients with chemotherapy related breakthrough vomiting in the first cycle were enrolled in this study. These patients were given olanzapine（10mg once daily, d1-d3）oral-ly before the second cycle of chemotherapy to prevent explosive vomiting. The nausea and vomiting of patients were scored according to the national cancer institute common terminology criteria for adverse events. The test was used to compare the differences of vomiting scores before and after receiving olanzapine. Results The vomiting scores of the 36 cases were significantly decreased （10？1＆#177;0？9 vs. 18？2＆#177;1？2, P=0？032） after combined with olanzapine in prevention. 47？2%（17/36） of the patients no longer had explosive vomiting after receiving olanzapine and 75？0% （ 9/12） of women patients no longer had vomiting after receiving olanzapine. The effective rate of olanzapine in prevention of vomitting was 80？0%. The main related side effects were dizziness and fatigue, and the incidences were 36？1% and 30？6%, respectively. Conclusion Olanzapine can effectively reduce the incidence of chemotherapy related breakthrough vomiting, and release the symptom of nausea and vomiting in cancer patients.

关 键 词：奥氮平 化学治疗 爆发性呕吐 

分 类 号：R730.53[医药卫生—肿瘤]