奥氮平在乳腺癌吡柔比星联合环磷酰胺化疗患者呕吐预防中的应用效果

Effect of Olanzapine on preventing vomiting in patients with breast cancer treated with Pirarubicin combined with Cyclophosphamide chemotherapy

目的探讨奥氮平在乳腺癌吡柔比星联合环磷酰胺(AC方案)化疗患者呕吐预防中的应用效果。方法选取2020年1月至2021年3月在上饶市人民医院接受AC方案化疗的50例乳腺癌患者作为研究对象,采用随机数字表法分为对照组和观察组,各25例。对照组采用昂丹司琼联合地塞米松预防,观察组在对照组基础上采用奥氮平预防,均连续干预2个周期。比较两组患者第1周期化疗后急性、延迟性及第2周期预期性的恶心、呕吐完全缓解(CR)率和1周期后锥体外系反应总发生率。结果两组患者第1周期急性CR率比较,差异无统计学意义(P>0.05);观察组第1周期急性与第1周期延迟性及第2周期预期性CR率比较,差异无统计学意义(P>0.05);观察组第1周期延迟性与第2周期预期性CR率比较,差异无统计学意义(P>0.05);观察组第1周期延迟性及第2周期预期性的CR率高于对照组,差异有统计学意义(P<0.05);对照组第1周期延迟性CR率、第2周期预期性CR率低于第1周期急性CR率,差异有统计学意义(P<0.05);对照组第1周期延迟性、第2周期预期性CR率比较,差异无统计学意义(P>0.05)。两组患者锥体外系反应总发生率比较,差异无统计学意义(P>0.05)。结论奥氮平可有效预防乳腺癌患者AC化疗方案导致的延迟性以及预期性恶心呕吐症状,且不增加锥体外系反应总发生率。

Objective To explore the effect of Olanzapine in the prevention of vomiting in breast cancer patients treated with Pirarubicin combined with Cyclophosphamide(AC)chemotherapy.Methods A total of 50 breast cancer patients who received AC chemotherapy in Shangrao People′s Hospital from January 2020 to March 2021 were selected as research subjects.They were divided into control group and observation group according to random number table method,with 25 cases in each group.The control group was treated with Ondansetron combined with Dexamethasone for prevention,the observation group was treated with Olanzapine for prevention on the basis of the control group.The acute,delayed complete remission(CR)rates of nausea and vomiting in the first cycle of chemotherapy and expected CR rate of nausea and vomiting in the second cycle of chemotherapy,the total incidence of extrapyramidal reaction after one cycle were compared between the two groups.Results There was no statistical significance in the rate of acute CR in the first cycle between the two groups(P>0.05).There was no statistical significance in the rate of acute CR in the first cycle,delayed CR in the first cycle and expected CR in the second cycle in the observation group(P>0.05).There was no statistical significance in the rate of delayed CR in the first cycle and expected CR in the second cycle in the observation group(P>0.05).The rates of delayed CR in the first cycle and expected CR in the second cycle in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The delayed CR rate of the first cycle and the expected CR rate of the second cycle in the control group were lower than the acute CR rate of the first cycle,the differences were statistically significant(P<0.05).There was no statistical significance between the delayed CR rate of the first cycle and the expected CR rate of the second cycle in the control group (P>0.05). There was no statistical significance in the total incidence of extrapyramidal reaction between the two groups (P>0.05). Conclusion Olanzapine is effective in preventing delayed and expected nausea and vomiting caused by AC chemotherapy in breast cancer patients, and does not increase the total incidence of extrapyramidal reactions.