地塞米松联合硫酸镁预防长春瑞滨所致静脉炎

Using dexamethasone and magnesium sulfate to prevent venous irritation by vinorelbine infusion in patients with advanced non-small cell lung cancer

目的长春瑞滨是目前最常用的化疗药物之一，它是缓和的发疱剂，能引起静脉炎。本研究旨在探讨地塞米松联合硫酸镁预防长春瑞滨所致静脉炎的效果。方法前睁1．生观察我科300例初治晚期非小细胞肺癌患者，化疗方案包含长春瑞滨，每周期评估静脉炎的程度。全组分为试验组和对照组各150例，试验组使用长春瑞滨前后用地塞米松2．5mg静脉注射，50％硫酸镁湿敷静脉穿刺点以上皮肤，从静脉用药前10min至结束后4—6h；对照组仅用药前后给予地塞米松2．5mg静脉注射，未用硫酸镁湿敷。结果试验组静脉注射长春瑞滨791次，其中39次（4．93％）发生静脉炎；对照组予807次静脉注射长春瑞滨，98次（12．14％）发生静脉炎，两组差异有统计学意义（P〈0．05）。试验组有8例发生静脉炎（5．33％），对照组19例发生静脉炎（12．67％），两组差异有统计学意义（P〈0．05）。结论地塞米松联合硫酸镁能预防长春瑞滨治疗非小细胞肺癌患者所致静脉炎的发生，增加患者对化疗的依从性。

Objective Vinorelbine is one of the most active chemotherapeutic agents. However, it is also a moderate vesicant that is well known to cause venous irritation and phlebitis. We conducted this study to evaluate the efficacy of combination dexamethasone and magnesium sulfate to prevent the venous irritation caused by peripheral vinorelbine infusion. Methods We prospectively investigate a total of 300 cases（150 vs. 150） of advanced non-small cell lung cancer treated with a chemotherapeutic regimen containing vinorelbine. Venous irritation was evaluated in every coarse and graded according to the National Cancer Institute Common Toxicity Criteria version 3.0. In experimental group, dexamethasone 2. 5rag was administered through a peripheral vein prior to vinorelbine infusion and followed by vinorelbine infusion, 50% magnesium sulfate was administered through wet dressing skin above venous injection site over a period of 4-6 hours, followed by vinorelbine infusion. In control group, magnesium sulfate was not administered. Results There was 39 times venous irritation in experimental group that achieved 791 times venous vinorelbine, compared to 98 times in control group that achieved 807 times（P 〈0. 05）. The incidence of venous irritation was 5.33% （8/150） in experimental group. In control group, the incidence of venous irritation was 12. 67% （19/150）. The difference between the two groups was statistically significant （P 〈 0.05）. Conclusion Dexamethasonc and magnesium sulfate can prevent the venous irritation caused by peripheral vinorelbine infusion in patients with advanced non-small cell lung cancer.