化疗相关性腹泻的临床研究

Clinical Study on Chemotherapy-induced Diarrhea

目的:探讨与化疗相关性腹泻发生时间相关的因素并评价去甲万古霉素在治疗化疗相关性腹泻方面的临床价值。方法:采用前瞻性研究方法,测定化疗相关性腹泻患者大便标本的菌群分布状况,并试验性应用去甲万古霉素为主的治疗方案。收集年龄、体质状况评分、肿瘤类型、临床分期、不同化疗方案、化疗相关性腹泻发生时间、去甲万古霉素疗效等临床资料。结果:在2778例常规化疗的患者中52例发生化疗相关性腹泻,男34例,女18例;年龄:最小5岁,最大68岁,平均53.93岁;KS评分:0分7例,1分6例,2分18例,3分17例,4分4例;肿瘤类型:消化道肿瘤17例,恶性淋巴瘤14例,肺癌9例,其他肿瘤12例。临床分期:Ⅰ期3例,Ⅱ期7例,Ⅲ期8例,Ⅳ期34例。腹泻发生时间:最短0d,最长35d。接受去甲万古霉素治疗后,47例有效。结论:有不同体质状况评分、不同化疗方案影响化疗相关性腹泻的发生时间(P<0.05)。而性别、年龄、肿瘤类型、临床分期不影响腹泻发生时间(P>0.05)。去甲万古霉素口服对治疗该种腹泻有效,有效率90.4%。

objective： To analysis the related factors of chemotherapy - induced diarrhea and evaluate the clinical efficacy and safety of demethylvacomycin in the treatment of chemotherapy - induced diarrhea. Methods： In 52 patients with chemotherapy- induced diarrhea, the distribution of flora was detected and demethylvacomycin was administrated. Theage, KS scores, tumor type, clinical staging, chemotherapy regimens, the time of onset of diarrhea and therapeutic effect were analyzed. Results： 52 of 2778 case routine chemotherapy developed diarrhea （34 males and 18 females, aged between 5 and 68 years） The KS scores was 0 in 7 cases, 1 in 6 cases, 2 in 8 cases, 3 in 17 cases and 4 in 4 cases. There were 17 cases with tumor in alimentary canal, 14 with malignant lymphoma, 9 pulmonary cancer and 12 with other types of tumors. 3 cases was in stage Ⅰ, 2 in stage Ⅱ 8 in stage and 34 in stage Ⅳ. The time of onset of diarrhea was between 0 and 35 days. 47 of 52 cases were effective in treatment with demethylvacomycin. Conclusion： The KS score and chemo therapy regimens involve in the time of oneset of chemotherapy - induced diarrhea. The sex, age, type of tumor and clinical staging are not related factors The demethylvacomycin is effective in treating chemotherapy - induced diarrhea.