二级预防对化疗所致中性粒细胞减少症的临床意义  

Clinical role of secondary prophylaxis in chemotherapy-induced neutropenia

作　　者：何迎盈[1] 陈兆红[1] 赵雷[1] 张友才 Ying-ying He;Zhao-hong Chen;Lei Zhao;You-cai Zhang(Department of Oncology,The People’s Hospital of Deyang City,Deyang,Sichuan 618000,China)

机构地区：[1]德阳市人民医院肿瘤科,四川德阳618000

出　　处：《中国现代医学杂志》2020年第13期84-89,共6页China Journal of Modern Medicine

摘　　要：目的探讨二级预防在化疗所致中性粒细胞减少症中的临床疗效、患者依从性及经济学评价。方法选取2017年4月-2018年10月德阳市人民医院肿瘤科诊断明确的,并使用中等风险化疗方案,有二级预防指征的患者131例作为研究对象。基于对中性粒细胞减少症的处理方式,将患者分为两组:A组72例,给予二级预防,根据使用的药物进一步分为A1组(37例)和A2组(35例)。A1组使用重组人粒细胞集落刺激因子(rhG-CSF)5μg/kg皮下注射;A2组使用聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)6 mg皮下注射。B组59例,化疗规律检测血常规,当出现2~4度粒细胞减少时,给予rhG-CSF 5μg/kg皮下注射。比较A、B组患者能够按既定周期足剂量化疗的病例数、3、4度粒细胞减少人次、发热性中性粒细胞减少症人次、化疗周期天数、患者依从病例数、非化疗医疗费用等指标。结果按周期足剂量化疗病例数:A组高于B组(P<0.05);3、4度粒细胞减少人次:A组少于B组(P<0.05);中性粒细胞减少症人次:A组少于B组(P<0.05);化疗周期平均天数:A组少于B组(P<0.05);依从率:A、B两组差异无统计学意义(P>0.05);非化疗产生费用:A组费用高于B组(P<0.05)。结论规范的二级预防能够明显减少发生3、4度粒细胞减少和中性粒细胞减少症的人次,能够较好地保证患者按周期足剂量完成化疗。选用rhG-CSF还是PEG-rhG-CSF进行二级预防,需要考虑患者依从性和经济条件。Objective To retrospectively observe the clinical efficacy,patient compliance and economic evaluation of secondary prophylaxis in chemotherapy-induced neutropenia.Methods From April 2017 to October 2018,131 patients with indications for secondary prophylaxis were observed,who were diagnosed clearly and given a medium-risk chemotherapy in Oncology Department in the People’s Hospital of Deyang City.Based on the treatment of neutropenia,patients were divided into two groups.Secondary prevention was conducted in group A(72 patients).Patients were further divided into two sub-groups.Thirty-seven patients in sub-group A1 were injected subcutaneously with recombinant human granulocyte colony stimulating factor(rhG-CSF)at a dose of 5μg/kg.Thirty-five patients in sub-group A2 were subcutaneously injected with pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF).Blood tests were performed regularly after chemotherapy in group B(59 patients).When grade 2 to 4 neutropenia occurred,rhG-CSF was injected subcutaneously at 5μg/kg.A series of items were compared in these groups,such as the number of patients receiving full-dose of chemotherapy at established cycles,frequency of 3 to 4 degree neutropenia and febrile neutropenia,days of chemotherapy cycle,patient compliance,non-chemotherapeutic consumption and so on.Results Composition ratio of patients receiving full-dose of chemotherapy at established cycles:ratio of group A was higher than that of group B(P<0.05);Composition ratio of 3 to 4 degree neutropenia’s frequency:ratio of group A was lower than that of group B(P<0.05);Composition ratio of FN’s frequency:ratio of group A was less than that of group B(P<0.05);Days of chemotherapy cycle:days of group A was less than that of group B(P<0.05);Ratio of Patients’compliance:the difference between two groups’ratio was not statistically significant(P>0.05);Non-chemotherapeutic consumption:consumption of group A was more than that of group B(P<0.05).Conclusion Standardized secondary prevention c

关 键 词：中性粒细胞减少 二级预防 化疗 

分 类 号：R730.53[医药卫生—肿瘤]