初诊非小细胞肺癌患者化疗所致恶心呕吐的动态变化及护理对策

Dynamic changes and nursing strategies of chemotherapy-induced nausea and vomiting in patients of newly diagnosed with non-small cell lung cancer

目的描述性分析初次确诊为非小细胞肺癌(NSCLC)患者首次吉西他滨联合顺铂(GP)化疗第1个化疗周期中化疗所致恶心呕吐(CINV)的情况,为制定针对性预防及护理措施提供参考。方法采用便利抽样法,选取2017年1—12月上海市肺科医院的165例NSCLC患者,在化疗第3、5、7、14天和第21天追踪随访其CINV的发生情况,记录CINV等级。结果第1个化疗周期中,恶心发生率为90.3%(149/165),多为2级,化疗第3~7天为高峰期;呕吐发生率为50.9%(84/165),多为1级,化疗第4~6天为高峰期。结论初诊NSCLC患者GP首次化疗后,CINV的高峰期为第3~7天,并持续3~5 d,医护人员可根据恶心、呕吐的高发时间窗及持续时间进行针对性、及时性的干预及护理,预防或减轻恶心、呕吐的发生。

Objective To descriptively analyze the dynamic changes of chemotherapy-induced nausea and vomiting in patients of newly diagnosed with non-small cell lung cancer (NSCLC) during the first chemotherapy cycle after first chemotherapy with gemcitabine plus cisplatin (GP), in order to provide targeted prevention and nursing during the peak period. Methods A total of 165 NSCLC patients from Shanghai Pulmonary Hospital from January to December 2017 were recruited by convenience sampling method. Chemotherapy-induced nausea and vomiting (CINV) were followed up on the 3rd, 5th, 7th, 14th, and 21st day of chemotherapy, and CINV grades were recorded. Results In the first chemotherapy cycle, the incidence of nausea was 90.3%(149/165), mostly in grade 2, and the peak period was the 3rd to the 7th day after chemotherapy, while the incidence of vomiting was 50.9%(84/165), mostly in grade 1, and the peak period was the 4th to the 6th days. Conclusions During the first chemotherapy cycle of GP regimen in patients newly diagnosed with NSCLC, the peak period of CINV was the 3rd to the 7th day, and lasted 3 to 5 days. According to the time window and duration of high incidence of nausea and vomiting, medical staff can intervene in a timely manner to prevent or reduce the occurrence of nausea and vomiting.