胃肠癌奥沙利铂化疗方案产生的神经毒性作用预防分析及护理方案
|
摘要
目的分析胃肠癌奥沙利铂化疗方案产生的神经毒性作用预防及护理。方法以该院2014年6月—2015年6月收治68例奥沙利铂化疗的胃肠癌患者,治疗组34例患者予以还原性谷胱甘肽静滴,对照组34例予以甲钴胺注射液静滴,并在治疗过程中对两组患者予以针对性护理,对比两组患者不同化疗周期神经毒性分度情况及不同化疗周期NSS评分。结果治疗4个周期内,对照组Ⅱ、Ⅲ度神经毒性发生率(5.9%)低于治疗组(11.8%),但治疗6个周期后,对照组Ⅱ、Ⅲ度神经毒性发生率(38.2%)高于治疗组(17.6%);治疗4个周期内对照组NSS评分(2.86±1.02)分低于治疗组(4.23±1.46)分,治疗6个周期对照组NSS评分(5.10±1.53)分高于治疗组(3.29±1.29)分,对比差异有统计学意义(P<0.05)。结论甲钴胺在前4周期效果较还原型谷光甘肽好,随着奥沙利铂使用量的蓄积,还原型谷光甘肽效果逐步开始显效。
Objective This paper tries to analyze the neurotoxicity, prevention and nursing of oxaliplatin chemotherapy in patients with gastrointestinal carcinoma. Methods 68 cases of oxaliplatin chemotherapy in gastrointestinal cancer in this hospital from June 2014 to June 2015 were selected, 34 cases of the treatment group were treated with reduced glutathione intravenously, 34 patients were treated with intravenous drip of mecobalamin injection, and in the course of treatment, the two groups of patients were given targeted nursing, division of neurotoxicity and different cycles of chemotherapy NSS score of patients with different chemotherapy cycle in two groups were compared. Results In the 4 cycles, the incidence of neurotoxicity of Ⅱ and Ⅲ degrees in the control group was 5.9%, lower than that in the treatment group of 11.8%, but after 6 cycles, the neurotoxicity of Ⅱ and Ⅲ degrees in the control group was 38.2%, higher than the treatment group of 17.6%; in the 4 cycles, the NSS score of the control group was(2.86±1.02)points, lower than that of the treatment group of(4.23±1.46)points. The NSS score of the 6-cycle in the control group was(5.10±1.53)points,higher than that of the treatment group of(3.29±1.29)points, the differences were statistically significant(P<0.05). Conclusion The effect of methycobal in 4 cycles is better than reduced glutathione, with the accumulation of oxaliplatin usage, the effect of glutathione is shown markedly.
Objective This paper tries to analyze the neurotoxicity, prevention and nursing of oxaliplatin chemotherapy in patients with gastrointestinal carcinoma. Methods 68 cases of oxaliplatin chemotherapy in gastrointestinal cancer in this hospital from June 2014 to June 2015 were selected, 34 cases of the treatment group were treated with reduced glutathione intravenously, 34 patients were treated with intravenous drip of mecobalamin injection, and in the course of treatment, the two groups of patients were given targeted nursing, division of neurotoxicity and different cycles of chemotherapy NSS score of patients with different chemotherapy cycle in two groups were compared. Results In the 4 cycles, the incidence of neurotoxicity of Ⅱ and Ⅲ degrees in the control group was 5.9%, lower than that in the treatment group of 11.8%, but after 6 cycles, the neurotoxicity of Ⅱ and Ⅲ degrees in the control group was 38.2%, higher than the treatment group of 17.6%; in the 4 cycles, the NSS score of the control group was(2.86±1.02)points, lower than that of the treatment group of(4.23±1.46)points. The NSS score of the 6-cycle in the control group was(5.10±1.53)points,higher than that of the treatment group of(3.29±1.29)points, the differences were statistically significant(P<0.05). Conclusion The effect of methycobal in 4 cycles is better than reduced glutathione, with the accumulation of oxaliplatin usage, the effect of glutathione is shown markedly.
引文
[1]胡峰明,傅旭春.奥沙利铂相关神经毒性及其影响因素分析[J].中国现代应用药学,2015,32(10):1253-1261.
[2]丁彩艳,薛嵋,吴洪斌,等.奥沙利铂致外周神经毒性症状特性及变化趋势的纵向研究[J].护理学杂志,2014,29(17):1-6.
[3]申思,吕春梅,冯海燕,等.奥沙利铂神经毒性反应的防治及护理进展[J].实用临床医药杂志,2016,20(10):197-200.
[4]张玮琨,刘燕.中西医治疗奥沙利铂神经毒性研究进展[J].湖南中医杂志,2016,32(10):204-206.
[5]谷麟,李雪松,刘东,等.奥沙利铂神经毒性机制及防治新进展[J].药物流行病学杂志,2017,26(6):429-435.
[6]高雯聪,王永林.替吉奥联合奥沙利铂治疗晚期胃癌的临床效果与不良反应观察[J].中国生化药物杂志,2017,(9):290-292.
[7]张官平,欧阳喜,潘华,等.结直肠癌患者SCN9A遗传变异与奥沙利铂外周神经毒性易感性研究[J].广东医学,2017,38(2):300-304,307.
[8]张帆,易峰涛,谢俊杰,等.加巴喷丁治疗奥沙利铂神经毒性的临床观察[J].中国新药杂志,2015,24(8):904-907.
[9]王强.黄芪桂枝五物汤手足浴联合钙镁合剂防治奥沙利铂神经毒性的临床观察[J].现代中西医结合杂志,2015,24(3):318-320.
[10]曹梦苒,华海清,秦叔逵.神经节苷脂预防奥沙利铂周围神经毒性的研究[J].肿瘤防治研究,2014,41(4):387-390.
[2]丁彩艳,薛嵋,吴洪斌,等.奥沙利铂致外周神经毒性症状特性及变化趋势的纵向研究[J].护理学杂志,2014,29(17):1-6.
[3]申思,吕春梅,冯海燕,等.奥沙利铂神经毒性反应的防治及护理进展[J].实用临床医药杂志,2016,20(10):197-200.
[4]张玮琨,刘燕.中西医治疗奥沙利铂神经毒性研究进展[J].湖南中医杂志,2016,32(10):204-206.
[5]谷麟,李雪松,刘东,等.奥沙利铂神经毒性机制及防治新进展[J].药物流行病学杂志,2017,26(6):429-435.
[6]高雯聪,王永林.替吉奥联合奥沙利铂治疗晚期胃癌的临床效果与不良反应观察[J].中国生化药物杂志,2017,(9):290-292.
[7]张官平,欧阳喜,潘华,等.结直肠癌患者SCN9A遗传变异与奥沙利铂外周神经毒性易感性研究[J].广东医学,2017,38(2):300-304,307.
[8]张帆,易峰涛,谢俊杰,等.加巴喷丁治疗奥沙利铂神经毒性的临床观察[J].中国新药杂志,2015,24(8):904-907.
[9]王强.黄芪桂枝五物汤手足浴联合钙镁合剂防治奥沙利铂神经毒性的临床观察[J].现代中西医结合杂志,2015,24(3):318-320.
[10]曹梦苒,华海清,秦叔逵.神经节苷脂预防奥沙利铂周围神经毒性的研究[J].肿瘤防治研究,2014,41(4):387-390.