肺癌化疗药物不同给药途径不良反应发生特点分析

Characteristics of Adverse Reaction Occurrence of Chemotherapeutic Drugs for Lung Cancer in Different Administration Routes

目的为肺癌化疗药物的个体化选择提供依据。方法收集某院2022年1月至2023年6月确诊为肺癌且接受化疗患者的临床资料,分析不同给药途径化疗疗程中药品不良反应(ADR)的发生情况。结果共纳入321例患者,其中男168例(52.34%),女153例(47.66%);年龄主要集中于41~80岁(313例,99.51%);肺癌类型以非小细胞肺癌最多,分期以Ⅳ期最多(129例,40.19%);接受单一、多种给药途径的分别有220例、101例;累计化疗1306次。最多见的给药途径为静脉给药[84.53%,尤其是外周静脉给药(46.02%)],周期给药剂量也以该途径最多;不同给药途径共同使用的药物为顺铂注射液。化疗药物在不同给药途径中的ADR,口服给药以消化系统表现(恶心、呕吐、腹泻、便秘)为主;外周静脉给药以静脉炎(28.29%,多采用MP方案治疗)为主,中心静脉给药以深静脉血栓(4.57%,多采用NP方案治疗)为主;胸腔灌注给药以胸膜反应(14.04%,多使用顺铂注射液治疗)为主,支气管动脉灌注给药以股动脉血肿(6.98%,多采用AMP方案治疗)为主。结论肺癌化疗药物经不同途径给药时的ADR及不同给药途径适应人群均不同,临床可根据患者实际情况开展个体化治疗。

Objective To provide a basis for individualized selection of chemotherapeutic drugs for lung cancer.Methods The clinical data of patients diagnosed with lung cancer and receiving chemotherapy in a hospital from January 2022 to June 2023 were collected,and the occurrence of adverse drug reactions(ADRs)induced by chemotherapeutic drugs in different administration routes were analyzed.Results A total of 321 patients were included,including 168 males(52.3~4%)and 153 females(47.66%),with ages mainly ranging from 41 to 80 years old(313 cases,99.51%);non-small cell lung cancer and stageⅣ(129 cases,40.19%)were the most common types;220 and 101 cases were given drugs in single and multiple routes of administration,respectively;1306 times of chemotherapy were involved.Intravenous administration was the most common route[84.53%,especially peripheral intravenous administration(46.02%)],with the most dosage in the cycle;the drug commonly used in different routes of administration was Cisplatin Injection.For the ADRs induced by chemotherapeutic drugs in different administration routes,the ADRs in oral administration were mainly digestive system symptoms such as nausea,vomiting,diarrhea,and constipation;the ADRs in peripheral intravenous administration were mainly phlebitis(28.29%,mostly treated with MP regimen),while the ADRs in central intravenous administration were mainly deep vein thrombosis(4.57%,mostly treated with NP regimen);the ADRs in chest perfusion were mainly pleural reactions(14.04%,mostly treated with Cisplatin Injection),while the ADRs in bronchial artery perfusion were mainly femoral artery hematoma(6.98%,mostly treated with AMP regimen).Conclusion Chemotherapeutic drugs for lung cancer in different routes of administration induce different ADRs,and different routes of administration are adapted to different populations.Individualized treatment can be carried out according to the actual status of patients.