血常规监测在头颈部恶性肿瘤同期放化疗中的干预作用  

Interventional effect of blood routine monitoring in concurrent chemoradiotherapy for head and neck malignancies

作　　者：陈婵娟[1] 陈秋华[1] 钟建雄[1] 张景佩 谭斌[2] CHEN Chanjuan;CHEN Qiuhua;ZHONG Jianxiong;ZHANG Jingpei;TAN Bin(Cancer Prevention and Treatment Center,Jiangmen Xinhui District People’s Hospital;Center pharmacy,Jiangmen Xinhui District People’s Hospital,Jiangmen,Guangdong 529100,China)

机构地区：[1]江门市新会区人民医院肿瘤防治中心,广东江门529100 [2]江门市新会区人民医院中心药房,广东江门529100

出　　处：《大医生》2022年第23期5-8,共4页Doctor

基　　金：江门市科技计划项目(编号:2020YLH026)。

摘　　要：目的探讨血常规监测在头颈部恶性肿瘤患者同期放化疗中的作用,为临床提供参考。方法选取2020年3月至2021年8月江门市新会区人民医院收治的60例中晚期头颈部恶性肿瘤患者作为研究对象,按照随机数字表法分为治疗组和对照组,各30例。两组患者均采用逆向调强放射治疗,常规分割,同期化疗采用铂类,加或不加靶向治疗。治疗组患者在每周一、周四上午常规检查1次血常规,对照组患者在每周五上午检查1次血常规,根据血常规结果,早期干预升高白细胞治疗。比较两组患者骨髓抑制程度及生存质量情况。结果治疗组患者骨髓抑制程度显著低于对照组(P<0.05);治疗组患者Karnofsky功能状态量表(KPS)评分升高占比多于对照组,KPS评分下降占比少于对照组(P<0.05)。两组患者减量化疗占比比较,差异无统计学意义(P>0.05),治疗组患者按期完成化疗占比多于对照组(P<0.05)。结论监测血常规指导早期干预升高白细胞治疗能显著降低肿瘤放化疗后骨髓抑制程度,保障放化疗顺利进行,提高患者生存质量。Objective To investigate the role of blood routine monitoring in concurrent chemoradiotherapy in patients with head and neck malignancies and provide a reference for clinical practice.Methods A total of 60 patients with advanced head and neck malignant tumors admitted to Jiangmen Xinhui District People’s Hospital from March 2020 to August 2021 were selected as the study subjects and divided into the treatment group and the control group according to the random number table,with 30 cases in each group.Patients in both groups were treated with reverse intensitymodulated radiation therapy,conventional fractionation,and concurrent chemotherapy with platinum,with or without targeted therapy.Patients in the treatment group were routinely examined for blood routine twice a week on Monday and Thursday mornings,and patients in the control group were examined for blood routine once every Friday morning.According to the results of blood routine,early intervention and WBC-elevating treatment were performed.Bone marrow suppression and quality of life were compared between the two groups.Results The degree of bone marrow suppression in the treatment group were significantly lower than that in the control group(P<0.05).The proportion of increased Karnofsky Performance Status scale(KPS)score in the treatment group was more than that in the control group,and the proportion of decreased KPS was less than that in the control group(P<0.05).There were no significant difference in the proportion of patients who underwent dose reduction chemotherapy between the two groups(P>0.05),and the proportion of patients who completed chemotherapy on schedule in the treatment group was more than that in the control group(P<0.05).Conclusion Monitoring blood routine guidance early intervention of WBC-elevating therapy can significantly reduce the degree of bone marrow suppression after chemoradiotherapy,ensure the smooth progress of chemoradiotherapy,and improve the quality of life of patients.

关 键 词：血常规 头颈部恶性肿瘤 同期放化疗 骨髓抑制 生存质量 

分 类 号：R735[医药卫生—肿瘤]