综合防治措施对大剂量阿糖胞苷巩固治疗小儿白血病不良反应的预防作用  

Comprehensive prevention and control measures for the treatment of large dose of acarbose consolidate children leukaemia prevention of adverse reactions

作　　者：申佳[1] 杨瀚[1] 

机构地区：[1]河南科技大学第一附属医院新区医院,河南洛阳471000

出　　处：《西安交通大学学报（医学版）》2015年第5期718-720,F0003,共4页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的探讨综合防治措施在大剂量阿糖胞苷巩固治疗小儿白血病过程中对不良反应预防及治疗作用。方法将2010年1月-2013年12月在河南科技大学第一附属医院新区医院接受以阿糖胞苷为主的综合用药治疗的30例小儿白血病患者分为2组,A组给予综合防治措施对治疗过程中的不良反应进行预防和治疗,B组给予常规的治疗措施。对比其不良反应发生情况,分析综合防治措施在不良反应预防及治疗中的作用。结果 A组15例患者共进行治疗50次,B组15例患者共进行治疗46次,在巩固治疗中出现的主要不良反应为药物热以及皮疹、神经系统毒性、消化系统毒副作用、骨髓抑制等,其中综合防治组神经系统毒性、消化系统毒副作用、药物热、皮疹及感染等不良反应的发生率均明显低于常规治疗组,差异有统计学意义;综合防治组骨髓抑制的发生率与常规治疗组无明显差异,但骨髓抑制分级明显低于常规治疗组,差异有统计学意义。结论综合防治措施应用于大剂量阿糖胞苷巩固治疗小儿白血病能够有效降低治疗过程中皮疹、药物热、神经系统毒性、消化系统毒副作用、感染等不良反应的发生率,降低骨髓抑制的严重程度,保证患儿安全地完成综合治疗。Objective To explore integrated preventive and control measures for adverse reactions in the process of high-dose cytarabine consolidation treatment of leukemia in children.Methods We divided 30 patients who received integrated cytarabine treatment for pediatric leukemia in our hospital between January 2010 and December 2013 into Group A and Group B.Group A received integrated preventive measures for preventing and treating adverse reactions during the treatment while Group B received conventional treatment measures. We compared the incidences of adverse reactions between patients in the two groups and analyzed the effect of the integrated preventive and control measures in preventing and treating adverse effects.Results In Group A15 patients were treated for 50 times,while 15 patients in Group B were treated for 46 times;the main adverse reactions that occurred in the consolidation therapy included myelosuppression,nervous system toxicity,digestive side effects,drug fever and skin rashes.The incidences of nervous system toxicity,digestive side effects,drug fever,rashes,infections and other adverse reactions were significantly lower in the integrated therapy group than in the conventional treatment group;however,the two groups did not differ significantly in the incidence of myelosuppression,but the classification of myelosuppression was significantly lower in the integrated treatment group.Conclusion Integrated preventive and control measures used in high-dose cytarabine consolidation therapy for children with leukemia can effectively reduce the incidence of such adverse reactions as skin rashes,drug fever,nervous system toxicity and digestive side effects and infections,and decrease the severity of myelosuppression to ensure children＇safe completion of the integrated treatment.

关 键 词：综合防治措施 阿糖胞苷 白血病 巩固治疗 不良反应 小儿 

分 类 号：R557[医药卫生—血液循环系统疾病]