肿瘤细胞减灭术后预防性应用重组人粒细胞集落刺激因子对晚期卵巢癌患者骨髓抑制继发感染的影响  

Effect of preventive recombinant human granulocyte colony-stimulating factor after cytoreductive surgery on infections secondary to bone marrow suppression in patients with advanced ovarian cancer

作　　者：刘莉娜 尤春华 徐蕊 赵欣 LIU Li'na;YOU Chunhua;XU Rui;ZHAO Xin(Department of Obstetrics and Gynecology,the Second People’s Hospital of Xinxiang,Xinxiang 453002,He’nan,China)

机构地区：[1]新乡市第二人民医院妇产科,河南新乡453002

出　　处：《癌症进展》2023年第23期2613-2616,共4页Oncology Progress

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190635)。

摘　　要：目的 分析肿瘤细胞减灭术(CRS)后预防性应用重组人粒细胞集落刺激因子(rhG-CSF)对晚期卵巢癌患者骨髓抑制继发感染的影响。方法 将154例行CRS治疗的晚期卵巢癌患者按随机数字表法分为观察组与对照组,每组77例。两组患者在CRS后均开展新辅助化疗,化疗方案为顺铂+紫杉醇,对照组每次化疗结束后1周时复查血常规,依据白细胞计数(WBC)、绝对中性粒细胞计数(ANC)水平皮下注射rhG-CSF直至WBC、ANC恢复正常;观察组在对照组的基础上自化疗开始时预防性给予rhG-CSF。比较两组患者WBC、ANC水平及WBC、ANC恢复至正常的时间,并统计骨髓抑制继发感染发生情况及抗菌药物使用时间。结果 化疗7、9、13、15、17天,观察组患者WBC水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。观察组化疗期间WBC减少总发生率明显低于对照组,WBC恢复至﹥4.0×10^(9)/L的时间明显短于对照组,差异均有统计学意义(P﹤0.01)。观察组患者ANC水平明显高于对照组,ANC恢复正常的时间明显短于对照组,差异均有统计学意义(P﹤0.01)。两组患者骨髓抑制后继发感染发生情况与抗菌药物使用时间比较,差异均无统计学意义(P﹥0.05)。结论CRS后预防性应用rhG-CSF虽未能对晚期卵巢癌患者骨髓抑制后继发感染风险产生显著的改善作用,但预防性应用rhG-CSF能减轻晚期卵巢癌患者WBC、ANC抑制,缩短其恢复至正常的时间,值得临床重视。Objective To analyze the effect of preventive recombinant human granulocyte colony-stimulating factor(rhG-CSF) after cytoreductive surgery(CRS) on infections secondary to bone marrow suppression in patients with advanced ovarian cancer.Method A total of 154 patients with advanced ovarian cancer treated by CRS were divided into the observation group(n=77) and the control group(n=77) by random number table.Both groups underwent neoadjuvant chemotherapy with cisplatin+paclitaxel after CRS.Hematology of the control group was examined again at 1 week after the end of each chemotherapy.According to white blood cell(WBC) and absolute neutrophil count(ANC),patients in the control group were treated with subcutaneous injection of rhG-CSF until WBC and ANC returned to normal levels.On this basis,patients in the observation group were treated with rhG-CSF prophylactically since the beginning of chemotherapy.WBC,ANC levels and time for WBC and ANC returning to normal levels were compared between the two groups.The incidence of infections secondary to bone marrow suppression and time of antibiotics usage were statistically analyzed.Result WBC levels in the observation group were significantly higher than those in the control group after 7,9,13,15,17 d of chemotherapy(P<0.01).The total incidence of WBC reduction in the observation group during chemotherapy was significantly lower than that in the control group,and the time for WBC returning to>4.0×10^(9)/L was significantly shorter than that in the control group(P<0.01).ANC level in the observation group was significantly higher than that in the control group,and the time for ANC returning to normal level was significantly shorter than that in the control group(P<0.01).There were no statistically significant differences in incidence of infections secondary to bone marrow suppression and time of antibiotics usage between the two groups(P>0.05).Conclusion Though preventive use of rhG-CSF after CRS can not significantly improve the infections secondary to bone marrow suppression

关 键 词：肿瘤细胞减灭术 重组人粒细胞集落刺激因子 晚期卵巢癌 骨髓抑制 感染 

分 类 号：R737.31[医药卫生—肿瘤]