【摘要】 目的分析晚期胃癌患者化疗中发生≥Ⅲ度严重不良反应的相关因素。方法 122例晚期胃癌患者分别给予5-氟尿嘧啶为基础的5种化疗方案治疗2周期,观察和记录给药期间发生的不良反应,分析性别、年龄、辅助化疗史、化疗方案以及化疗效果等与≥Ⅲ度的骨髓抑制、腹泻、恶心/呕吐、口腔黏膜炎、肝损伤、外周神经炎等严重不良反应的关系。结果性别和年龄与严重不良反应无关;既往有辅助化疗史者,其≥Ⅲ度的严重腹泻和严重口腔黏膜炎发生率显著高于无辅助化疗史者(P=0.0314和0.0084)。不同化疗方案的严重骨髓抑制和严重肝损伤发生率具有非常显著的差异(P=0.0071和0.0089)。化疗效果与严重不良反应的发生率呈正相关关系,即严重不良反应的发生率随着化疗效果的提高而上升。结论晚期胃癌化疗中的严重不良反应产生与患者的既往辅助化疗史、化疗方案以及化疗效果相关。研究结果可以为晚期胃癌化疗方案和护理措施的选择提供参考依据。更多还原

【Abstract】 Objective To analyze the related factors of Ⅲ degree seriously adverse reactions during the chemotherapy in patients with advanced gastric cancer. Methods 122 patients with advanced gastric cancer were treated with 5 chemotherapy based on fluoropymidine( 5-Fu) regimens in two cycles. The adverse reactions that occurred during the administration were observed and recorded. The relationship between gender,age,adjuvant chemotherapy history,chemotherapy regimen and chemotherapy effect and other serious adverse reactions such as grade Ⅲ myelosuppression,diarrhea,nausea and vomiting,oral mucositis,liver injury and peripheral neuritis were analysed. Results The gender and age were not associated with serious adverse reactions. In the past,the patient with assisted chemotherapy history,whose the incidence of grade Ⅲ severe diarrhea and severe oral mucositis was significantly higher than those without adjuvant chemotherapy( P = 0. 0314 and 0. 0084). There was an obviously significant difference in the incidence of severe myelosuppression and severe liver injury among different chemotherapy regimens( P = 0. 0071 and 0. 0089). There was positively correlation between the effect of chemotherapy and the incidence of serious adverse reactions,that is,the incidence of serious adverse reactions increased with the improvement of chemotherapy. Conclusion The serious adverse reactions in advanced gastric cancer chemotherapy are related to the patients’ assisted chemotherapy history,chemotherapy regimen and the effect of chemotherapy. These findings can provide a reference for the choice of chemotherapy regimens and nursing measures for advanced gastric cancer.更多还原