帕洛诺司琼联合小剂量地塞米松治疗顺铂致恶心呕吐的临床观察

Clinical study of palonosetron combined with decreased dexamethasone to prevent nausea and vomiting induced by eisplatin

目的探讨帕洛诺司琼联合小剂量的地塞米松在防治顺铂引起的恶心、呕吐中的疗效和安全性。方法采用随机信封方法将60例采用顺铂化疗的肿瘤患者分为对照组（29例）和联合组（31例）。对照组用药为盐酸帕洛诺司琼注射液0．25mg，第1、3天静脉注射；联合组在对照组基础上联合地塞米松5mg／d，第1～3天静脉推注。对化疗后恶心呕吐疗效进行评价，并观察地塞米松所致的不良反应。结果化疗期间，对照组急性呕吐有效22例（75．9％），无效7例（24．1％），延迟性呕吐有效20例（69．0％），无效9例（31．0％）。联合组急性呕吐有效24例（77．4％），无效7例（22．6％）；延迟性呕吐有效26例（83．9％），无效5例（16．1％）。联合组对于延迟性呕吐疗效优于对照组（P〈0．05）。地塞米松应用期间，发生血压和血糖升高2例，兴奋1例，失眠1例，皮疹1例，但均可控制。结论盐酸帕洛诺司琼注射液联合小剂量的地塞米松能够预防化疗引起的延迟性恶心、呕吐，疗效和安全性较好。

Objective To investigate the efficacy and safety of palonosetron hydrochloride combined with decreased dexamethasone in prevention of nausea and vomit induced by cisplatin. Methods All cases were randomly divided into two groups, 29 cases in control group （treated with palonosetron 0.25 mg） and 31 cases in combined group （treated with palonosetron 0.25 mg and dexamethasone 5 nag）. Results Effective rate of acute vomit in combined group was higher than that in control group [77.4% （24 cases） vs 75.9% （22 cases）, P 〉 0. 05 ] ; effective rate of delayed emesis in combined group was also higher that in control group, the difference was statistically significant [ 83.9% （ 26 eases ） vs 69.0% （ 20 eases ）, P 〈 0.05 ]. Increased incidence of blood pressure and serum glucose, insomnia, agitation, skin rash were observed when dexamethasone was used. Conclusion Palonosetron hydrochloride combined with decreased dexamethasone is effective and safe for prevention of delayed nausea and vomit induced by cisplatin.