奥氮平联合格拉司琼及地塞米松预防肿瘤化疗所致恶心、呕吐及对睡眠障碍干预的临床疗效观察

摘要

Objective To explore the effects of olanzapine combined with granisetron and dexamethasone in the prevention chemotherapy-induced emesis, nausea and the sleep disorder in cancer patients.Methods We enrolled 60 patients with chemotherapeutic drugs and randomly divided into observation group (olanzapine combined with granisetron and dexamethasone) and control group (granisetron combined with dexamethasone), 30 cases in each group. The control group was given routine antiemetic drugs, the observation group based on routine antiemetic drugs combined with olanzapine 10mg, from day 1 to day 4 per night. The time of above administration plan is consistent with the time of chemotherapy. Compare the curative effect and adverse reaction between the two groups in the control of acute and delayed nausea and vomiting, and observe the effect of the sleep quality of the patients.Results The observation group and the control group acute nausea, vomiting incidence of 6.67% (2/30) and 13.3% (4/30) respectively, and the difference is not statistically signiifcant (P>0.05); delayed nausea and vomiting rate was 3.33% (1/30) and 23.33% (7/30), insomnia incidence was 0% (0/30) and 33.3% (10/30) respectively, and the difference was statistically signiifcant (P<0.05); During treatment, two groups of adverse reactions were dizziness (6.67% and 10%), sleepiness (16.67%and 13.33%), constipation (6.67% and 6.67%), and there was no signiifcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Olanzapine combined with granisetron and dexamethasone on highly emetogenic drugs induced nausea and vomiting has better therapeutic effects, especially for delayed nausea and vomiting, can improve the quality of sleep in patients with chemotherapy, adverse reactions can be tolerated, worth clinical promotion.%目的：观察奥氮平联合格拉司琼及地塞米松在预防恶性肿瘤化疗所致恶心、呕吐的疗效及安全性，并观察奥氮平对患者化疗期间睡眠质量的影响。方法对60例应用化疗药物的患者，随机分为观察组（奥氮平联合格拉司琼、地塞米松）和对照组（格拉司琼联合地塞米松），每组30例。对照组给予常规药物止吐，观察组在常规止吐药物的基础上加用奥氮平10 mg，每晚口服d1~4。以上给药方案的时间与化疗时间一致。比较两组控制急性和延迟性恶心、呕吐的疗效差别及不良反应，并观察对患者睡眠质量的影响。结果观察组与对照组急性恶心、呕吐发生率分别为6.67%（2/30）和13.3%（4/30），差异无统计学意义（P＞0.05）；延迟性恶心、呕吐发生率为3.33%（1/30）和23.33%（7/30），失眠的发生率分别为0%（0/30）和33.3%（10/30），差异有统计学意义（P＜0.05）；治疗期间两组不良反应主要有头晕10.0%（3/30）和6.67%（2/30）、嗜睡16.67%（5/30）和13.33%（4/30）、便秘（6.67%和6.67%），两组不良反应发生率无统计学差异（P>0.05）。结论奥氮平联合格拉司琼及地塞米松对中高度致吐药物所致恶心、呕吐有较好的防治作用，特别是对延迟性恶心、呕吐的疗效更优，能改善化疗患者睡眠质量，不良反应可耐受，值得临床推广。