睡前服用奥氮平预防顺铂高致吐性化疗方案所致恶心呕吐的疗效观察  

Observation on the efficacy of taking olanzapine before bedtime to prevent nausea and vomiting caused by cisplatin-containing highly emetogenic chemotherapy

作　　者：张慕华 王匀 陈嘉宁 刘国满 ZHANG Mu-hua;WANG Yun;CHEN Jia-ning(Department of Pharmacy,Gaoyao District People's Hospital,Zhaoqing 526040,China)

机构地区：[1]广东省肇庆市高要区人民医院药学部,526040 [2]广东省肇庆市高要区人民医院肿瘤综合治疗中心,526040

出　　处：《中国现代药物应用》2022年第7期167-170,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究睡前服用奥氮平预防顺铂高致吐性化疗方案所致恶心呕吐的临床疗效。方法82例接受含顺铂高致吐性风险化疗方案的患者作为研究对象,随机分成观察组和对照组,每组41例。观察组采用奥氮平联合托烷司琼、地塞米松和甲氧氯普胺预防呕吐方案治疗,对照组采用托烷司琼、地塞米松和甲氧氯普胺预防呕吐方案治疗。对比两组急性(0~24 h)和迟发性(>24 h)化疗所致恶心呕吐(CINV)的发生情况、患者止吐效果(CINV完全缓解率、CINV控制有效率)以及记录观察组患者使用奥氮平所引起的不良反应发生情况。结果观察组急性CINV发生率为14.63%明显低于对照组的43.90%,CINV完全缓解率、CINV控制有效率分别为85.37%、97.56%,均高于对照组的56.10%、70.73%,差异均具有统计学意义(P<0.05)。观察组迟发性CINV发生率为29.27%明显低于对照组的63.41%,CINV完全缓解率为70.73%明显高于对照组的36.59%,差异均具有统计学意义(P<0.05)。两组CINV控制有效率对比,差异无统计学意义(P>0.05)。观察组发生头晕头痛3例,发生率为7.32%;嗜睡1例,发生率为2.44%;总不良反应发生率为9.76%(4/41)。结论睡前服用奥氮平联合5-羟色胺3(5-HT_(3))受体拮抗剂、激素在预防含顺铂高致吐性化疗方案所致的急性和迟发性CINV的有效控制率较高,且耐受性良好,值得临床推广应用。Objective To investigate the clincial efficacy of taking olanzapine before bedtime to prevent nausea and vomiting caused by cisplatin-containing highly emetogenic chemotherapy.Methods A total of 82 patients who received cisplatin-containing highly emetogenic chemotherapy were selected as the research subjects and randomly divided into observation group and control group,with 41 cases in each group.The observation group was treated with olanzapine combined with tropisetron,dexamethasone and metoclopramide to prevent vomiting,while the control group was treated with tropisetron,dexamethasone and metoclopramide to prevent vomiting.The incidence of acute(0-24 h)and delayed(>24 h)chemotherapy-induced nausea and vomiting(CINV),antiemetic effect(complete remission rate of CINV,control efficiency of CINV)were compared between the two groups and the occurrence of adverse effects caused by the use of olanzapine was recorded in the observation grop.Results The incidence of acute CINV in the observation group was 14.63%,which was significantly lower than 43.90%in the control group,and the CINV complete remission rate and CINV control effeciency were 85.37%and 97.56%,which were higher than 56.10%and 70.73%in the control group.All the differences were statistically significant(P<0.05).The incidence of delayed CINV 29.27%in the observation group was significantly lower than 63.41%in the control group,and the complete remission rate of CINV 70.73%was significantly higher than 36.59%in the control group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in CINV control effeciency between the two groups(P>0.05).In the observation group,3 cases of dizziness and headache occurred,with an incidence of 7.32%;1 case of drowsiness,with an incidence of 2.44%;the overall incidence of adverse reactions was 9.76%(4/41).Conclusion Taking olanzapine combined with serotonin 3(5-HT_(3))receptor antagonist and hormone before bedtime can prevent acute and delayed CINV caused by cisplatin-c

关 键 词：睡前服用 奥氮平 顺铂 化疗 恶心呕吐 

分 类 号：R730.5[医药卫生—肿瘤]