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[目的]观察小剂量奥氮平在改善女性肺癌患者高致吐性化疗导致的延迟性恶心和呕吐上的疗效及安全性。[方法]120例接受高致吐性化疗(顺铂70mg/m~2,联合以下任一:多西紫杉醇60mg/m~2,紫杉醇150mg/m~2,吉西他滨1.0g/m~2,培美曲塞500mg/m~2和依托泊苷350mg/m~2)的女性肺癌患者随机分为对照组和研究组。两组在化疗前30min均予以地塞米松(5mg静脉注射)、托烷司琼(5mg静脉注射),研究组在对照组基础上接受奥氮平(5mg口服,每日1次,连服4d)。监测患者的延迟性恶心呕吐,评估奥氮平治疗延迟性恶心和呕吐的疗效。[结果]120例患者中117例可评价。在观察期间,59例接受奥氮平的患者中有19例(32.2%)出现呕吐,对照组中有32例(55.2%)出现呕吐(P=0.012)。研究组和对照组出现恶心的患者比例分别为45.8%(27/59)和79.3%(46/58)(P<0.01)。3级或4级骨髓抑制的发生率分别为8.5%(5/59)和10.3%(6/58)(P=0.729)。[结论 ]在接受高致吐性化疗的女性肺癌患者中,加用小剂量奥氮平可明显改善化疗所致的延迟性恶心呕吐,且不良反应少,不增加患者的治疗总费用。
[Objective] To observe the efficacy and safety of low-dose olanzapine in improving the delayed nausea and vomiting caused by hyperememetic chemotherapy in women with lung cancer. [Methods] One hundred and twenty patients received high-epithelial chemotherapy (cisplatin 70mg/m~2, combined with any of the following: docetaxel 60mg/m~2, paclitaxel 150mg/m~2, gemcitabine 1.0g/m~2, Patients with lung cancer 500 mg/m2 and etoposide 350 mg/m~2 were randomized into control and study groups. Both groups received dexamethasone (5 mg intravenously) and tropisetron (5 mg intravenously) 30 min before chemotherapy. The study group received olanzapine on the basis of the control group (5 mg orally, once daily, even for 4 days. ). Patients were monitored for delayed nausea and vomiting and evaluated for efficacy of olanzapine in the treatment of delayed nausea and vomiting. [Results] Of the 120 patients, 117 were evaluated. During the observation period, 19 (32.2%) of the 59 patients receiving olanzapine experienced vomiting, and 32 (55.2%) of the control group had vomiting (P=0.012). The proportion of nausea patients in the study and control groups was 45.8% (27/59) and 79.3% (46/58), respectively (P<0.01). The incidence of Grade 3 or 4 bone marrow suppression was 8.5% (5/59) and 10.3% (6/58), respectively (P=0.729). [Conclusion] Adding low-dose olanzapine can significantly improve delayed nausea and vomiting caused by chemotherapy in women with lung cancer receiving high-efflux chemotherapy, with fewer adverse reactions and without increasing the total cost of treatment.