帕洛诺司琼、托烷司琼、昂丹司琼预防肝动脉化疗栓塞术后所致呕吐疗效的临床观察

Efficacies of palonosetron,tropisetron and ondansetron in preventing vomiting after transcatheter arterial chemoembolization

目的比较帕洛诺司琼与托烷司琼、昂丹司琼用于预防肝动脉化疗栓塞术后所致恶心呕吐的疗效及不良反应。方法将结直肠癌术后肝转移行肝动脉化疗栓塞术的患者120例随机分为3组,每组40例,A组使用盐酸托烷司琼注射液5 mg术前1 h内静脉滴注,B组使用盐酸昂丹司琼胶囊8 mg术前1 h口服,C组使用盐酸帕洛诺司琼注射液0.25 mg术前1 h内静脉注射。3组患者术后不再使用其他止吐药,必要时予甲氧氯普胺10 mg肌内注射进行解救性止吐治疗。结果3组在预防急性呕吐时,完全缓解率分别为67.5%、65.0%、70.0%,差异无统计学意义(P>0.05);在预防延迟性呕吐时,C组患者的完全缓解率达到87.5%,高于A组(70.0%)和B组(60.0%),差异有统计学意义(P<0.05)。3组患者的不良反应主要是便秘、腹胀,症状轻微。结论帕洛诺司琼、托烷司琼、昂丹司琼预防肝动脉化疗栓塞术后所致恶心呕吐均有较好的效果,不良反应轻微可控,但盐酸帕洛诺司琼对于延迟性呕吐的疗效更优。

Objective To compare the efficacies and adverse reactions of palonosetron hydrochloride with tropisetron and ondansetron in the prevention of nausea and vomiting after transcatheter arterial chemoembolization.Methods A total of 120 patients with postoperative liver metastasis of colorectal cancer who underwent transcatheter arterial chemoembolization were randomly divided into three groups.One hour before surgery,tropisetron hydrochloride(5 mg)was intravenously dripped in group A,ondansetron hydrochloride capsule(8 mg)was orally administered in group B,and palonosetron hydrochloride(0.25 mg)was intravenously injected in group C.No other antiemetics were used after surgery,and if necessary,intramuscular injection of metoclopramide(10 mg)was given for rescue.Results The complete response rates in preventing acute vomiting were 67.5%in group A,65.0%in group B,and 70.0%in group C,with no statistically significant difference(P>0.05).The complete response rate in preventing delayed vomiting was 87.5%in group C,which was significantly higher than those in group A(70.0%)and group B(60.0%)(P<0.05).The main adverse reactions in the three groups were mild constipation and abdominal distension.Conclusion Palonosetron,tropisetron,and ondansetron have satisfactory effects on preventing postoperative nausea and vomiting caused by transcatheter arterial chemoembolization,with mild and controllable adverse reactions.Palonosetron hydrochloride has a better effect on delayed vomiting.