2016年5～10月华中科技大学同济医学院附属协和医院含奥沙利铂化疗方案不良反应分析

目的 分析华中科技大学同济医学院附属协和医院含奥沙利铂化疗方案不良反应的规律及特点，为临床合理应用提供参考。方法 搜集2016年5~10月华中科技大学同济医学院附属协和医院含奥沙利铂化疗方案的不良反应357例，对患者基本情况、不良反应具体分布情况、患者用药情况、不良反应干预用药等多方面进行分析。结果 357例病例中有289例不良反应报告，发生率为80.95%。女性的不良反应发生率高于男性患者，各年龄段患者不良反应发生率相差不大。KPS评分为100分的患者不良反应发生率最高，为91.07%。不良反应主要集中在血液系统、胃肠道系统、外周神经系统和过敏反应4个方面，其中胃肠道不良反应发生率最高为54.62%，胃肠道系统包括恶心、呕吐、腹泻、便秘等。FOLFOX方案所致的不良反应例数最多，为362例。不同厂家奥沙利铂患者不良反应发生率相差不大。化疗分布最多的第2周期不良反应发生率为84.06%，第10~13周期不良反应发生率均为100.00%。预先使用了地塞米松的患者不良反应发生率为79.47%。给药速度为50、55滴/min的没有不良反应发生。结论 在奥沙利铂临床用药时，应积极规避不良反应风险，保障患者的安全用药。

Analysis on adverse reactions of chemotherapy regimens contained oxaliplatin in Union Hospital Tongji Medical College, Huazhong University of Science and Technology from May to October 2016

Objective To analyze the laws and characteristics of adverse reactions of chemotherapy regimens contained oxaliplatin in Union Hospital Tongji Medical College, Huazhong University of Science and Technology, and provide references for the promotion of rational clinical application. Methods 357 Cases of adverse reaction reports from May to October 2016 in Union Hospital Tongji Medical College, Huazhong University of Science and Technology were selected and analyzed according to the patient''s basic situation, specific distribution of adverse reactions, patient''s medication, and intervention drugs of adverse reactions.Results There were 289 cases of adverse reactions reported in 357 cases, with the incidence rate of 80.95%. The adverse reaction rate of female was higher than that of male. There was no significant difference between patients with different ages. Patients with KPS score of 100 had the highest adverse reaction rate (91.07%). The adverse reactions of oxaliplatin were mainly focused on blood system, gastrointestinal system, peripheral nervous system, and allergic reaction. The adverse reaction rate of gastrointestinal system was the highest (54.62%), including nausea, vomiting, diarrhea, and constipation. The case of adverse reaction induced by FOLFOX method was the most (362 cases). There was no significant difference between oxaliplatin from different manufacturers. Most chemotherapy was in second cycle, and the adverse reaction rate was 84.06%. The adverse reaction rates of 10-13 cycle were 100.00%. The adverse reaction rate of patients with perusing dexamethasone was 79.47%. There was no adverse reaction in injection speed of 50 and 55 drops/min. Conclusion During the use of oxaliplatin in clinic, the adverse reaction risk should be positively avoided, to ensure patient''s safe medication.