格拉司琼加地塞米松预防含顺铂化疗所致恶心呕吐的临床观察

目的:观察格拉司琼与地塞米松联用预防含顺铂的联合化疗所致的恶心、呕吐及其他不良反应,并与单用格拉司琼比较.方法:采用随机、交叉、自身对照法,将40例接受含顺铂80 mg/(m2·d)的联合化疗的恶性肿瘤患者,随机分为A、B两组.A组第1周期用格拉司琼,第2周期用格拉司琼加地塞米松;B组第1周期用格拉司琼加地塞米松,第2周期用格拉司琼.止吐方案:格拉司琼3 mg,静注,第1～3天,地塞米松10 mg,静注,第1～3天.结果:格拉司琼加地塞米松(联合组)第1～6天无恶心和轻度恶心的发生率均高于单用格拉司琼(单用组),其中第1～4和第6天差异有显著性(P＜0.05).联合组第1～6天呕吐完全控制率和有效控制率均高于单用组,其中第2、3天差异有显著性(P＜0.05).结论:地塞米松能增强格拉司琼对含顺铂化疗所致的恶心、呕吐的控制,可作为预防和控制含顺铂联合化疗所致恶心、呕吐的理想用药,值得临床推广.     

帕洛诺司琼预防高致吐性化疗所致恶心呕吐临床研究

目的:通过帕洛诺司琼和格拉司琼分别联合地塞米松预防以大剂量顺铂为主方案化疗所致恶心呕吐,观察和评价帕洛诺司琼联合地塞米松预防高致吐性化疗方案的疗效和安全性.方法:56例非小细胞肺癌患者接受以大剂量顺铂为主化疗方案,随机分为两组:治疗组28例,对照组28例.治疗组:帕洛诺司琼0.25 mg,静脉推注;对照组:格拉司琼3 mg,静脉滴注;两组均联合地塞米松12 mg,静脉推注,均于化疗前30min给药.结果:治疗组和对照组预防急性呕吐的完全有效率分别为82.1%和78.6%,恶心的改善率分别为64.3%和60.7%,差异均无显著性(P>0.05);治疗组和对照组预防延迟性呕吐的完全有效率分别为60.7%和39.3%,差异有显著性(P<0.05).结论:帕洛诺司琼和格拉司琼分别联合地塞米松预防以大剂量顺铂为主方案化疗所致急性呕吐和恶心疗效相当,对于延迟性呕吐的完全有效率前者优于后者,不良反应轻,患者耐受性良好,推荐帕洛诺司琼联合地塞米松作为高致吐性化疗方案的常规药物.     

格拉司琼联合地塞米松预防含顺铂方案化疗所致恶心呕吐的疗效观察

我院自2001年8月～2003年10月采用自身对照法观察格拉司琼联合地塞米松与单用格拉司琼防治含顺铂联合化疗引起恶心、呕吐的疗效。现报告如下。     

帕洛诺司琼对比托烷司琼在预防晚期肺癌恶性胸腔积液胸腔化疗所致恶心呕吐的疗效观察

目的评价帕洛诺司琼在预防晚期肺癌恶性胸腔积液胸腔化疗所致恶心止吐的疗效并与托烷司琼对比。方法46例晚期肺癌伴恶性胸腔积液需行顺铂胸腔化疗的患者随机分为实验组（帕洛诺司琼组,n=23）和对照组（托烷司琼组,n=23）,观察并比较两组病人预防恶心止吐的效果及不良反应。结果实验组和对照组的急性恶心有效控制率分别为87．0％和78．3％,急性呕吐有效控制率分别为73．9％和60．9％,两组相比无显著性差异（P〉0．05）;在迟发性恶心和呕吐有效控制率方面,帕洛诺司琼组分别为78．3％和69．6％,托烷司琼组分别为47．8％和34．8％,两者具有显著性差异（P〈0．05）。治疗期间有部分患者出现腹胀、便秘及头晕,两组相比无显著性差异（P〉0．05）。结论帕洛诺司琼与托烷司琼在预防晚期肺癌恶性胸腔积液患者行顺铂胸腔化疗所致急性恶心呕吐的疗效相当,但对于迟发性恶心呕吐帕洛诺司琼有更好的效果。     

阿瑞匹坦用于晚期乳腺癌化疗的止吐效果观察

目的观察阿瑞匹坦对晚期乳腺癌患者应用含顺铂化疗方案后止吐效果及安全性。方法选取我院2014年1月—2016年5月使用含顺铂化疗方案的晚期乳腺癌56例,按照随机数字表法分为观察组及对照组,每组各28例。观察组于化疗首日用药前1 h口服阿瑞匹坦125 mg/d,第2、3天晨起口服阿瑞匹坦80 mg/d,同时予格拉司琼、地塞米松各5 mg/d静脉推注;对照组予安慰剂、格拉司琼及地塞米松,剂量及方法与观察组相同。结果两组急性恶心、迟发性恶心、急性呕吐、迟发性呕吐、急性恶心并呕吐发生率比较差异无统计学意义(P0.05);与对照组比较,观察组迟发性恶心并呕吐发生率降低,差异有统计学意义(P=0.043)。观察组无恶心呕吐17例,对照组无恶心呕吐9例,差异有统计学意义(P0.05)。两组其他不良反应比较差异无统计学意义(P0.05),且阿瑞匹坦未发生相关中重度药物不良反应。结论阿瑞匹坦对应用含顺铂化疗方案的晚期乳腺癌患者止吐效果好,安全性高。     

地塞米松在预防乳腺癌蒽环类化疗致呕吐的效果

目的:观察地塞米松在预防乳腺癌蒽环类化疗所致消化道反应中的疗效.方法:对129例接受以蒽环类联合化疗的乳腺癌患者,随机分成两组,A组接受化疗前给予格拉司琼针3 mg静推及地塞米松针5 mg静推,B组接受化疗前给予格拉司琼针3mg静推,观察两组48h内消化道反应情况.结果:两组的恶心、呕吐有效控制率分别为84.1%和66.7%(P<0.05).结论:地塞米松联合格拉司琼可以有效减少乳腺癌术后蒽环类化疗所致呕吐发生,是一种疗效高、价格低廉、安全有效的止吐方法.     

枢星联合方案预防顺铂(DDP)致恶心呕吐的观察及护理

目的:研究枢星联合方案(枢星联合地塞米松及胃复安)预防顺铂联合化疗所致恶心呕吐的疗效及护理干预。方法:将93例接受以顺铂为主联合化疗的患者随机分为两组,实验组53例接受70周期化疗并给予护理干预;对照组40例接受57周期常规化疗,观察1~5d,对两组恶心、呕吐控制率进行比较。结果:实验组对急性恶心、呕吐控制率分别为90%及94.3%,均较对照组(77.2%和80.87%)明显提高(P<0.05)。结论:枢星联合方案结合护理干预可较好地预防顺铂所致的急性恶心、呕吐,使患者以更为舒适的状态接受化疗。     

格拉司琼联合胃复安预防腰硬联合麻醉剖宫产术中术后恶心呕吐的疗效观察

观察格拉司琼联合胃复安对预防腰硬联合麻醉剖宫产术中术后恶心呕吐的效果。选取择期腰硬联合麻醉下行剖宫产的初产妇240例,采用随机数字表法将其分为A、B、C3组各80例。A组采用格拉司琼联合胃复安、B组采用格拉司琼联合地塞米松、C组单用格拉司琼预防术中术后恶心呕吐。三组产妇在麻醉开始前5min静脉注射相应的药物,并记录各组术中及术后0~2h和2~24h内恶心呕吐的发生情况。记录手术时间、出血量、术中低血压的发生情况和药物不良反应。A组术中恶心呕吐的发生率明显低于其他两组(P<0.05),三组术后0~24h恶心呕吐的发生率差异无统计学意义(P>0.05)。择期剖宫产行腰硬联合麻醉的产妇,在麻醉前预防性使用格拉司琼和胃复安能有效降低术中恶心呕吐的发生率。     

盐酸帕洛诺司琼预防高中度致吐性化疗所致胃肠道反应的安全性和有效性评价

【目的】探讨帕洛诺司琼预防化疗引起的急性和迟发性恶心、呕吐的疗效和不良反应。【方法】采用多中心、随机、双肓、自身交叉对照的研究方法。试验药为帕洛诺司琼（B药）,对照药为托烷司琼（A药）,对顺铂或蒽环类药物为基础的方案化疗后用药后1～5d内的恶心、呕吐程度、止吐疗效以及不良反应进行评价。【结果】预防中度和高度致吐性化疗A药急性呕吐完全控制率50．00％,B药53．78％,两组间比较差异无统计学意义（P=0．5701）。预防中度和高度致吐性化疗A药延迟性呕吐完全控制率35．83％,B药49．58％,两药间比较差异有统计学意义（P=0．0410）,使用B药完全控制率高于A药。不良反应症状主要为头痛、便秘等。【结论】帕洛诺司琼预防中重度致吐性化疗所引起的急性和迟发性呕吐疗效显著,安全性高。     

电子止吐仪联合盐酸阿扎司琼防治奈达铂化疗所致恶心、呕吐的疗效观察

[目的]探讨电子止吐仪联合盐酸阿扎司琼防治奈达铂化疗所致恶心、呕吐的临床疗效。[方法]将160例接受奈达铂化疗的病人随机分为试验组和对照组各80例。试验组应用电子止吐仪联合盐酸阿扎司琼止吐,对照组单用盐酸阿扎司琼止吐,记录两组病人化疗开始到化疗后第7天恶心、呕吐以及其他不良反应的发生情况。[结果]试验组病人呕吐的完全控制率和有效率分别为72.50%,93.75%,对照组为53.75%,81.25%;试验组恶心完全控制率和有效率分别为65.00%,91.25%,对照组为42.50%,77.50%,两组呕吐、恶心的完全控制率和有效率比较差异均有统计学意义(P0.05)。两组头晕、口渴、便秘等不良反应发生率比较差异无统计学意义(P0.05)。[结论]电子止吐仪与盐酸阿扎司琼联合用于预防奈达铂化疗所致呕吐、恶心效果优于单用盐酸阿扎司琼。     

DG及DP方案治疗晚期非小细胞肺癌的临床研究

目的 探讨多西紫杉醇＋吉西他滨（DG方案）和多西紫杉醇＋顺铂(DP方案)治疗晚期非小细胞肺癌的临床疗效和毒性反应。方法 经病理学或细胞学确诊不可手术的Ⅲb／Ⅳ期NSCLC患者125例,DG组65例,DP组60例。DG组：多西紫杉醇100㎎/㎡,d1;吉西他滨1 100㎎/㎡,d1、8。DP组:多西紫杉醇100㎎/㎡,d1; 顺铂80㎎/㎡,d2。对临床疗效和毒副反应进行对比观察。结果 有效率DG组为46.2%,DP组为45%,两组差异无统计学意义（P﹥0.05）。DG组和DP组中位生存期分别为12.4月和11.7月,一年生存率为50.8%和46.7%,均无统计学差异（P >0.05）。毒副反应均以骨髓抑制、胃肠反应为主,可耐受。DP组Ⅲ~Ⅳ度白细胞下降、恶心/呕吐、腹泻较DG组严重（P﹤0.05）。其他毒副反应相似。结论 DG方案和DP方案治疗晚期NSCLC均具有较好的耐受性和疗效,毒副反应可以耐受。DG方案毒副反应较DP方案更少、更轻,可作为晚期NSCLC较理想的化疗方法之一。     

Control of emsis by intravenous granisetron in breast cancer patients treated with 5-FU,epirubicin and cyclophosphamide

Granisetron, a potent and selective 5-hydroxytryptamine receptor (5-HT₃) antagonist was reported to be an effective antiemetic agent both in animal studies and in patients given highly emetogenic chemotherapy. A sample of 43 patients with breast cancer was accrued from September to November 1992 in a phase II study to assess the efficacy of granisetron in patients receiving FEC (5-FU, epirubicin, cyclophosphamide). Each patient received 3 mg intravenous granisetron as a single dose just prior to chemotherapy. Oral metoclopromide was prescribed to each patient as a rescue anti-emetic. The emetic episodes and degree of nausea were evaluated on a daily basis. Good control of emesis (0–2 episodes of vomiting) and nausea (mild or no nausea) was in the range 77%–98% and 77%–93% respectively. There was a complete response (no emetic episodes throughout the 6-day period) in 16 patients (37.2%). Onset of emesis tends to occur on day 1 and tend to subside after day 3; 85% of patients had onset of emesis in the first 2 days after chemotherapy. Control of emesis and nausea tends to improve after day 3, which could be the result of the reduced emetogenicity of the combination FEC with time. Altogether, 77% had good control of acute emesis; control of delayed emesis was better with 84% achieving a major response on day 2 after chemotherapy, which improved to more than 90% after day 4. Granisetron was generally tolerated with headache being the most common side-effect folloed by constipation and flushing. This study suggests that granisetron is an effective and well-tolerated anti-emetic agent, which deserves randomised trials to elucidate its efficacy further.     

参麦注射液联合白介素-2对肺癌术后化疗患者免疫功能及生活质量的影响

[目的]探讨参麦注射液联合白介素-2 (IL-2)对肺癌术后化疗患者免疫功能、化疗毒性及生活质量的影响.[方法]82例非小细胞肺癌患者,随机分为两组,对照组在手术基础上采取术后化疗并胸腔内注射IL-2.观察组在对照组基础上加用参麦注射液,比较两组相关治疗情况.[结果]观察组治疗胸腔积液总有效率为83.3％,高于对照组62.5％,且差异有显著性(P＜0.05).两组治疗前免疫功能指标、各项生活质量评分相比较差异均无显著性(P＞0.05);治疗后对照组各指标均无明显变化(P＞0.05),观察组治疗后CD3+、CD4+、CD4+/CD8+,功能量表、整体生活质量量表评分均高于;症状量表、单项量表评分,CD8+低于治疗前及对照组治疗后(P＜0.05).观察组Ⅲ度恶心呕吐,白细胞减少发生率分别为4.8％(2/42)和7.1％(3/42),低于对照组20.0％(8/40)和30.0％(12/40),且差异有显著性(均P＜0.05).两组其他毒副反应发生率相比较差异均无显著性(P＞0.05)[结论]参麦注射液联合IL-2治疗肺癌可有效缓解患者胸腔积液情况,增强患者免疫功能,减轻毒副作用,从而促进生活质量的提高.     

奥美拉唑、左氧氟沙星、阿莫西林三联疗法治疗幽门螺杆菌感染

[摘要]目的：探讨奥美拉唑、左氧氟沙星、阿莫西林三联一周疗法治疗幽门螺杆菌(Hp)感染的疗效及安全性。方法：选择90例Hp阳性慢性胃炎和消化性溃疡患者，随机分为两组。治疗观察组采用奥美拉唑(20 mg，2次／天)，左氧氟沙星(200mg，2次／天)，阿莫西林(1000 mg，2 次／天)，治疗7天。对照组采用奥美拉唑(20mg，2次／天)和克拉霉素(250 mg，2次／天)，阿莫西林(1000 mg，2次／天)，治疗7天；溃疡患者继用奥美拉唑20 mg，1 次／天，3周。疗程结束4周后复查Hp，观察症状缓解率、Hp根除率、溃疡治愈率、不良反应发生率等。结果：治疗组和对照组的症状缓解率、Hp根除率、溃疡治愈率、不良反应发生率分别为92.6％、90.2％ 、90.2％ 、4.8％ 和88．1％ 、85.7％ 、92.9％ 、4.8％ 。两组差异无显著性(P>0．05)。结论：奥美拉唑、左氧氟沙星、阿莫西林三联一周疗法是根除Hp的理想方案，可被作为根除Hp一线治疗方案。     

电针加中医护理改善急性腰扭伤疼痛的效果

目的 探讨电针加中医护理改善急性腰扭伤疼痛的作用.方法 选择2012年3月-2013年1月在上海交通大学附属第六人民医院就诊的急性腰扭伤患者96例,随机分为观察组48例和对照组48例.观察组采用电针加中医护理,包括中药熏蒸和点穴,对照组单纯采用电针治疗.观察两组患者治疗后疼痛改善情况.结果 在治疗第3、5天观察组患者疼痛减轻程度与对照组比较差异有统计学意义（P＜0.05）;治疗5天后,观察组总有效率为97.9％,对照组总有效率为89.6％,两组比较差异有统计学意义（P＜0.05）.结论 电针结合中医护理有利于减轻急性腰扭伤患者的腰痛,缩短疗程,促进患者早日康复.     

躯干肌肌力训练与牵伸对慢性腰痛的康复作用观察

目的探讨躯干肌肌力训练与牵伸对慢性腰痛患者的疗效和预防其复发的效果。方法46例慢性腰痛患者随机分为观察组和对照组,观察组采用超短波、躯干肌肌力训练与牵伸;对照组采用超短波、腰背部和下肢传统中医按摩。结果两组经过5个疗程治疗后,观察组总有效率为86.96％,对照组总有效率为65.21％,两组有显著性差异（P<0.05）。结论躯干肌肌力训练与牵伸对慢性腰痛患者的疗效明显并肥有效的防治其复发。     

Randomized, double-blinded, placebo-controlled trial of ondansetron plus dexamethasone with or without metoclopramide as antiemetic prophylaxis in patients receiving high-dose cisplatin in medical practice

Purposes  

Ondansetron plus dexamethasone are standard antiemetic agents for highly emetogenic chemotherapy. Metoclopramide is a dopamine antagonist, which may enhance efficacy of ondansetron and dexamethasone. The objective of this study was to assess the efficacy and tolerability of metoclopramide added to standard antiemetic regimen for prophylaxis of cisplatin-induced emesis.     

A double-blind, crossover, randomized comparison of granisetron and ramosetron for the prevention of acute and delayed cisplatin-induced emesis in patients with gastrointestinal cancer: is patient preference a better primary endpoint?

BACKGROUND: Serotonin receptor antagonists are recommended by the American Society of Clinical Oncology for the prevention of acute and delayed chemotherapy-induced emesis. However, the most effective agent in this class of antiemetic drugs for preventing emesis has not been clearly defined. We therefore performed a double-blind, crossover, randomized, controlled trial comparing the efficacy of granisetron and ramosetron, using patient preference as the primary endpoint. METHODS: Thirty patients receiving two courses of combined chemotherapy (including > or =60 mg/m(2) cisplatin) for gastric or esophageal cancer were randomly assigned to the granisetron-ramosetron group (treatment phase 1: granisetron, 3 mg; treatment phase 2: ramosetron, 0.3 mg) or the ramosetron-granisetron group (treatment phase 1: ramosetron, 0.3 mg; treatment phase 2: granisetron, 3 mg). All patients received methylprednisolone sodium, 250 mg i.v., during each treatment phase. RESULTS: The efficacy of granisetron and ramosetron was similar in terms of the suppression of emesis and appetite status. However, the majority of patients (19/30, 63.3%) expressed a preference for granisetron, as compared with 9 patients (30.0%) who preferred ramosetron; 2 patients (6.7%) had no preference (chi(2) test: p = 0.008; Fisher's exact test: p = 0.015). CONCLUSIONS: (1) A significant proportion of patients prefer granisetron over ramosetron for the prevention of chemotherapy-induced emesis. (2) Granisetron and ramosetron possess similar effectiveness for the suppression of emesis. (3) The variable of 'patient preference' should be accepted as a primary endpoint of antiemetic drug efficacy.     

Palonosetron (Aloxi®) and dexamethasone for the prevention of acute and delayed nausea and vomiting in patients receiving multiple-day chemotherapy

OBJECTIVE: The objective of this study was to determine the efficacy of palonosetron combined with dexamethasone in prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) in patients receiving multiple-day chemotherapy and the efficacy of a second dose of palonosetron in treating breakthrough emesis. MATERIALS AND METHODS: Forty-six patients treated with multiple-day chemotherapy for hematologic malignancies received palonosetron as prophylaxis for CINV on the first day of chemotherapy and dexamethasone throughout the entire period of chemotherapy. If breakthrough emesis occurred, a second dose of palonosetron was administered after 72 h following the first administration. The results were retrospectively compared to group of patients with similar clinical characteristics undergoing similar multiple-day chemotherapy. This group had received single-dose ondansetron as CINV prophylaxis on the first day of chemotherapy plus dexamethasone throughout the entire period of chemotherapy and metoclopramide for breakthrough emesis. RESULTS: One hundred eighty and 173 chemotherapy cycles were administered in the palonosetron and ondansetron groups, respectively. Nausea and vomiting were absent in 80% of patients of the palonosetron group and 60% of the control group (p < 0.05). In the palonosetron group, 67% of patients who experienced CINV were successfully rescued by a second dose of palonosetron, while in the ondansetron group, only 22% showed a no CINV after metoclopramide treatment (p = 0.04). CONCLUSIONS: The present results appear to be encouraging in terms of complete prophylaxis of CINV and treatment of breakthrough emesis in the setting of multiple-day chemotherapy.     

综合护理干预对急性脑外伤患者围术期抢救效果及预后的影响分析

目的探究综合护理干预对急性脑外伤患者围术期抢救效果及预后的影响。方法将本院收治的122例急性脑外伤患者作为研究对象,按入院先后分为综合护理组68例和常规护理组54例,分别给予综合护理干预和常规护理干预。就2组患者在围术期的抢救效果及预后情况进行对比性分析。结果综合护理组的抢救进行时间以及住院时间均低于常规护理组,且综合护理组的死亡率(1.47%)也低于常规护理组(9.26%),差异有统计学意义(P0.05)。护理干预后,综合护理组的NIHSS评分低于常规护理组,其GCS评分、FMA评分以及Barthel指数均显著高于常规护理组(P0.05)。综合护理组患者的并发症发生率为8.82%,显著低于常规护理组(24.07%),组间比较有统计学意义(P0.05)。结论综合性护理干预能够提高急性脑外伤的抢救效果,同时使其神经认知功能、肢体运动功能及日常生活能力得到显著改善,并发症发生率显著降低,值得在临床上积极推广。