奥氮平联合托烷司琼及地塞米松预防含顺铂化疗方案致呕吐的临床观察

Clinical observation of olanzapine combined with tropisetron and dexamethasone in preventing vomiting induced by cisplatin-containing chemotherapy

目的:探讨奥氮平联合托烷司琼及地塞米松预防含顺铂化疗方案致呕吐的临床效果。方法:收集2017年6月—2019年6月收治的60例恶性肿瘤并使用含顺铂方案行一线化疗患者,将其随机均分为观察组(n=30)和对照组(n=30)。对照组予以托烷司琼+地塞米松治疗,观察组在此基础上联合奥氮平治疗,记录并对比两组患者延迟性化疗导致的恶心呕吐反应(CINV)与急性CINV及外周血淋巴细胞亚群和外周血免疫球蛋白水平。结果:观察组患者延迟性CINV总发生率和急性CINV均低于对照组(P<0.05);干预后观察组患者外周血淋巴细胞亚群水平明显高于对照组(P<0.05);干预后观察组患者外周血免疫球蛋白明显低于对照组(P<0.05)。结论:对恶性肿瘤并使用含顺铂方案行一线化疗患者实施奥氮平联合托烷司琼及地塞米松治疗,可明显减少恶心呕吐反应,改善机体外周血淋巴细胞亚群与血免疫球蛋白水平。

Objective:To investigate the clinical observation of olanzapine combined with tropisetron and dexamethasone in preventing vomiting induced by cisplatin chemotherapy.Methods:Sixty patients with malignant tumors from June 2017 to June 2019 were enrolled.Patients with first-line chemotherapy with cisplatin were randomly divided into study group(n=30)and control group(n=30),in which the control group was treated with tropisetron+dexamethasone.The study group was treated with olanzapine.The patients with delayed chemotherapy-induced nausea and vomiting(CINV)and acute CINV and peripheral blood lymphocyte subsets were recorded.Group and peripheral blood immunoglobulin levels were analyzed and compared.Results:The total incidence of delayed CINV and the total incidence of acute CINV in the observation group were lower than those in the control group(P<0.05).The peripheral blood lymphocyte subsets in the observation group after intervention were significantly higher than those in the control group(P<0.05).The peripheral blood immunoglobulin of the observation group was significantly lower than that of the control group(P<0.05).Conclusion:Olanzapine combined with tropisetron and dexamethasone in patients with malignant tumors and first-line chemotherapy with cisplatin can significantly reduce nausea and vomiting,and improve peripheral blood lymphocyte subsets and blood immunoglobulin levels.