甲地孕酮对晚期恶性肿瘤化疗镇吐以及血凝功能影响

Effect of Megestone on Antiemetic and Hemagglutination Function of Chemotherapy in Advanced Malignant Tumor

目的探讨甲地孕酮对晚期恶性肿瘤中高致吐方案化疗致恶心、呕吐(chemotherapy induced nausea and vomiting,CINV)镇吐作用以及血凝功能影响。方法选取2018年1月~2020年12月笔者医院收治晚期恶性肿瘤化疗患者80例,80例确诊恶性肿瘤患者分为对照组和观察组,各40例。对照组常规给予5-HT 3受体拮抗剂和地塞米松镇吐,观察组在此基础上化疗前1h给予甲地孕酮480mg,每天1次,至化疗第7天停用。观察两组患者急性CINV和延迟性CINV发生率、血栓发生率以及血凝4项和D-二聚体变化情况。结果对照组急性CINV发生率为55.0%,观察组急性CINV发生率为20.0%,两组比较,差异有统计学意义(P<0.05);对照组延迟性CINV发生率为42.5%,观察组延迟性CINV发生率为15.0%,两组比较差异有统计学意义(P<0.05);观察组患者总体生活质量、躯体功能、角色功能、情感功能、社会功能方面评分均高于对照组,差异有统计学意义(P<0.05),两组认知功能比较,差异无统计学意义(P>0.05)。化疗后PT、APTT、TT、FIB、D-二聚体、PLT两组比较,差异无统计学意义(P>0.05)。结论中、高致吐方案化疗给予甲地孕酮可以显著减少CINV发生,提高化疗后生活质量,且化疗期间应用对患者血凝功能无显著影响。

Objective To investigate the effect of megestone on vomiting and antiemetic effect and hemagglutination function induced by chemotherapy(CINV)in advanced malignant tumor.Methods From January 2018 to December 2020,80 patients with advanced malignant tumor undergoing chemotherapy and 80 patients with confirmed malignant tumor were selected and divided into observation group and control group,with 40 cases in each group.The control group was routinely given 5-HT 3 receptor antagonist and dexamethasone,and the observation group was given megestrol 480mg 1 hour before chemotherapy,1/d,until the 7th day of chemotherapy.The incidence of acute CINV,delayed CINV,thrombosis,hemagglutination and D-dimer in 2 groups were observed.Results The incidence of acute CINV was 55.0%in the control group and 20.0%in the observation group,and the difference between the two groups was statistically significant(P<0.05).The incidence of delayed CINV was 42.5%in the control group and 15.0%in the observation group,with statistically significant difference between the two groups(P<0.05).The scores of overall quality of life,physical function,role function,emotional function and social function of patients in the observation group were higher than those in the control group,with statistical significance(P<0.05),while there was no statistical significance in cognitive function between the two groups(P>0.05).After chemotherapy,there were no significant differences in PT,APTT,TT,FIB,D-dimer and PLT between the two groups(P>0.05).Conclusion The administration of megestrol before and after chemotherapy of medium and high emetogenic regimens can significantly reduce CINV and improve the quality of life after chemotherapy,while the simultaneous use of megesterone chemotherapy has no significant effect on hemagglutination function.