奥氮平预防胃肠道肿瘤化疗所致爆发性呕吐临床研究

Clinical research of olanzapine in prevention of explosive vomiting caused by gastrointestinal tumor chemotherapy

目的 探讨奥氮平预防胃肠道肿瘤化疗所致爆发性呕吐的效果.方法 对146例胃肠道恶性肿瘤患者进行第1周期化疗,选择发生爆发性呕吐的42例患者纳入研究,在第2周期化疗前给予奥氮平口服,比较联合奥氮平预防前后恶心、呕吐症状评分和呕吐程度分级,统计总有效率,观察不良反应发生情况.结果 奥氮平干预后恶心、呕吐评分显著降低（P〈0.01）,呕吐程度分级情况明显优于干预前（P〈0.01）,按照疗效评价标准,干预后完全控制11例,基本控制17例,轻度控制6例,总有效率为80.95%;不良反应主要为1~2级的嗜睡、疲劳和头晕,未见3~4级的毒性反应.结论 奥氮平可有效减少胃肠道恶性肿瘤患者化疗期间爆发性呕吐的发生,减轻恶心、呕吐症状,提高患者的生活质量,且不良反应轻微,有临床应用价值.

Objective To investigate the effect of olanzapine on prevention of gastrointestinal tumor explosive vomiting caused by chemotherapy.Methods A total of 146 patients with gastrointestinal tumor underwent the first cycle of chemotherapy, 42 patients with explosive vomiting were included in the study group, and given olanzapine orally before the second cycle of chemotherapy, symptom scores of nausea and vomiting classification before and after the prevention of olanzapine using were compared, the total effective rate was counted and adverse reactions was observed.Results Nausea and vomiting scores after using olanzapine intervention decreased significantly （P〈0.01）, the degrees of vomiting were obviously better than those before intervention（P〈0.01）.According to the curative effect evaluation standard, 11 cases were completely controlled after intervention, 17 cases were basic control, 6 cases were mild control, the total effective rate was 80.95%.Adverse reactions were main drowsiness in 1-2 levels, fatigue and dizziness, toxic reaction in 3-4 levels was not found.Conclusions Olanzapine can effectively reduce the occurrence of explosive vomiting during chemotherapy in patients with gastrointestinal tract malignant tumor, relieve the symptoms of nausea and vomiting, improve the treatment of the patient＇s life, and the adverse reactions are mild, so it has clinical application value.