肿瘤儿童急性化疗所致恶心呕吐预防用药指南依从性现状及影响因素分析  

Analysis of the guidelines-accordance rate and influencing factors of acute chemotherapy-induced nausea and vomiting in children with cancer

作　　者：邓军 杨玉云 刘龙珍 管惠捷 蔡瑞卿[1] DENG Jun;YANG Yuyun;LIU Longzhen;GUAN Huijie;CAI Ruiqing(State Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat-sen University Cancer Center,Guangdong Province,Guangzhou510060,China)

机构地区：[1]华南恶性肿瘤防治全国重点实验室广东省恶性肿瘤临床医学研究中心中山大学肿瘤防治中心,广东广州510060

出　　处：《中国医药导报》2025年第10期114-119,共6页China Medical Herald

摘　　要：目的探讨肿瘤儿童急性化疗所致恶心呕吐预防用药指南依从性现状并分析影响因素。方法根据便利抽样法,选择2022年1月至12月就诊于中山大学肿瘤防治中心儿童肿瘤科的住院患者476例作为调查对象,采用自行设计的资料收集表调查患者的一般资料、疾病相关资料、化疗方案、化疗所致急性恶心呕吐的预防用药情况和指南依从性,采用二元logistic回归分析指南依从性的影响因素。结果476例肿瘤儿童化疗所致急性恶心呕吐的预防用药方案指南依从率为35.9%。不同年龄,体表面积,化疗前进食减少,睡眠不足,既往(恶心、呕吐)史,既往化疗所致恶心、呕吐控制不佳,疾病诊断,治疗阶段,首次化疗,化疗天数,化疗方案,化疗方案致吐风险的指南依从率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示:年龄,既往(恶心、呕吐)史,既往居家使用止吐药物,初治阶段,单日化疗,化疗致吐风险是指南依从性的影响因素(P<0.05)。结论肿瘤儿童化疗所致急性恶心呕吐预防用药指南依从性较低,需重点关注高风险人群并提升指南依从率以改善症状。Objective To investigate the guideline compliance with antiemetic prophylaxis against acute chemotherapy-induced nausea and vomiting in pediatric oncology patients,and to analyze the influencing factors of guideline compliance.Methods According to the convenience sampling,476 pediatric oncology inpatients admitted to the Department of Pediatric Oncology,Sun Yat-sen University Cancer Center between January and December 2022 were recruited.A self-designed data collection form was used to investigate the general data,disease-related data,chemotherapy regimen,antiemetic prophylaxis and guideline compliance with acute chemotherapy-induced nausea and vomiting,and binary logistics regression was used to analyze the influencing factors for guideline compliance.Results A total of 476 pediatric oncology patients were enrolled,and the guidelines compliance rate for antiemetic prophylaxis against acute chemotherapy-induced nausea and vomiting was 35.9%.There were significant differences in the guideline compliance rate were observed among different of age,body surface area,food intake decreases before chemotherapy,insufficient sleep,history of nausea and vomiting,poor previous control of chemotherapy-induced nausea and vomiting,disease diagnosis,treatment stage,first chemotherapy cycle,number of chemotherapy days,chemotherapy regimen,and emetic risk of the chemotherapy regimen(P<0.05).Multivariate logistic regression analysis revealed that age,history of nausea and vomiting,history of using antiemetic drugs at home,stage of initial treatment,single-day chemotherapy regimens and higher emetic risk were the influencing factors for guideline compliance(P<0.05).Conclusion The guidelines compliance for the antiemetic prophylaxis against acute chemotherapy-induced nausea and vomiting is low,and it is necessary to focus on high-risk groups and improve compliance with guidelines to improve symptoms.

关 键 词：肿瘤 儿童 化疗所致恶心呕吐 指南依从率 影响因素 

分 类 号：R730.53[医药卫生—肿瘤]