奥氮平联合托烷司琼在化疗相关性恶心呕吐中的临床疗效分析

Clinical efficacy of olanzapine combined with tropisetron in chemotherapy-induced nausea and vomiting

目的探讨奥氮平联合托烷司琼在化疗相关性恶心呕吐(CINV)中的临床疗效。方法60例接受中高度致吐风险化疗方案治疗的恶性肿瘤患者,随机分为对照组及观察组,每组30例。对照组化疗前使用托烷司琼+地塞米松治疗,观察组在对照组基础上使用奥氮平治疗。对比两组的恶心呕吐事件发生情况、恶心呕吐症状评分、卡氏功能状态(KPS)评分、爆发性呕吐发生情况、不良反应发生情况及生活质量评分。结果观察组急性、延迟性恶心呕吐事件Ⅰ~Ⅳ级发生率分别为26.67%、23.33%,明显低于对照组的66.67%、60.00%,差异具有统计学意义(P<0.05)。观察组恶心呕吐症状评分(7.07±2.11)分、爆发性呕吐发生率43.33%低于对照组的(9.24±2.43)分、73.33%,差异具有统计学意义(P<0.05)。化疗后,观察组KPS评分(73.32±9.87)分明显高于对照组的(67.68±10.73)分,差异具有统计学意义(P<0.05)。观察组不良反应发生率为23.33%,与对照组的26.67%比较,差异无统计学意义(P>0.05)。化疗后1周,观察组生理状况、功能状况、情感状况、社会/家庭状况评分分别为(12.11±1.23)、(12.47±1.34)、(12.80±1.32)、(12.02±1.31)分,明显低于对照组的(14.29±1.46)、(15.06±1.62)、(15.41±1.63)、(14.09±1.48)分,差异具有统计学意义(P<0.05)。结论奥氮平联合托烷司琼用于CINV的防治效果更好,能有效减少恶心呕吐事件发生率,降低恶心呕吐程度,减少爆发性呕吐的发生,改善生活质量,且用药安全性好,具有积极的临床意义。

Objective To discuss the clinical efficacy of olanzapine combined with tropisetron in chemotherapy-induced nausea and vomiting(CINV).Methods A total of 60 patients with malignant tumors who received medium-high emetogenic risk chemotherapy regimen were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with tropisetron combined with dexamethasone before chemotherapy,and the observation group was treated with olanzapine on the basis of the control group.The occurrence of nausea and vomiting,nausea and vomiting symptom score,Karnofsky performance status(KPS)score,occurrence of explosive vomiting,occurrence of adverse reactions and the quality of life score were compared between the two groups.Results The incidence of gradeⅠ-Ⅳacute and delayed nausea and vomiting events in the observation group was 26.67%and 23.33%,which were significantly lower than 66.67%and 60.00%in the control group,and the difference was statistically significant(P<0.05).The nausea and vomiting symptom score(7.07±2.11)points and the incidence of explosive vomiting 43.33%in the observation group were lower than(9.24±2.43)points and 73.33%in the control group,and the differences were statistically significant(P<0.05).After chemotherapy,the KPS score(73.32±9.87)points of the observation group was significantly higher than(67.68±10.73)points of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 23.33%,which was not statistically significant compared with 26.67%in the control group(P>0.05).1 week after chemotherapy,the scores of physiological status,functional status,emotional status,and social/family status of the observation group were(12.11±1.23),(12.47±1.34),(12.80±1.32),and(12.02±1.31)points,which were significantly lower than(14.29±1.46),(15.06±1.62),(15.41±1.63),and(14.09±1.48)points of the control group,and the differences were statistically significant(P<0.05).Conclusion Olanzapine combined with tropisetron has better efficacy in the prevention and treatment of CINV, and can effectively reduce the incidence of nausea and vomiting events and the occurrence of explosive vomiting, improve the quality of life with high safety, which contains positive clinical significance.