醋酸甲地孕酮在肿瘤化学疗法患者中的应用及护理_West China Medical Journal

Authors：

 袁灵 ,  李秋 , 汪秀云

四川大学华西医院腹部肿瘤科（成都 610041）;

Corresponding author：

李秋, Email: fbqiu9@163.com

Keywords：

醋酸甲地孕酮; 抑制; 恶心呕吐; 效果

DOI：

10.7507/1002-0179.20150158

Video：

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目的观察醋酸甲地孕酮（MA）对肿瘤患者化学疗法（化疗）期间恶心、呕吐症状的抑制效果及不良反应。方法采用前瞻性、自身前后对照研究，将2013年3月－9月入院的60例化疗肿瘤患者随机分为A、B两组。每组30例。A组在第1周期化疗前2 d开始口服MA，160 mg/d，连续口服5 d；托烷司琼5 mg/d，化疗前30 min静脉滴注，化疗第1～3天；第2周期单用托烷司琼。B组在第2周期口服MA+静脉滴注托烷司琼，第1周期单用托烷司琼，余同前。化疗结束后比较用MA和不用MA时的恶心、呕吐发生率和程度，以及便秘、血栓、面色潮红、阴道出血、血糖升高及水钠潴留等不良反应发生率。结果患者用MA时恶心、呕吐发生率较不用MA时明显降低（P＜0.05），恶心、呕吐程度也较不用MA时减轻（P＜0.05）。用MA和不用MA的便秘发生率比较，差异无统计学意义（P＞0.05）。两组均未见血栓、面色潮红、阴道出血、血糖升高及水钠潴等不良反应。结论与不使用MA比较，肿瘤患者使用MA能明显减轻化疗引起的恶心、呕吐反应，且不增加其他不良反应发生率。

Citation： 袁灵, 李秋, 汪秀云. 醋酸甲地孕酮在肿瘤化学疗法患者中的应用及护理. West China Medical Journal, 2015, 30(3): 548-550. doi: 10.7507/1002-0179.20150158 Copy

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1. Lohr L. Chemotherapy-induced nausea and vomiting[J]. Cancer J, 2008, 14(2):85-93.
2. 崔慧娟. 醋酸甲地孕酮在晚期肿瘤治疗中的应用进展[J]. 国外医学:肿瘤学分册, 2001, 28(6):473-474.
3. Navari RM, Brenner MC. Treatment of cancer-related anorexia with olanzapine and megestrol acetate:a randomized trial[J]. Support Care Cancer, 2010, 18(8):951-956.
4. Passalacqua R, Cocconi G, Caminiti C, et al. Double-blind, multicenter, randomized trial to compare the effect of two doses of adrenocorticotropic hormone versus placebo in controlling delayed emesis after high-dose cisplatin in adult patients with cancer[J]. J Clin Oncol, 1997, 15(6):2467-2473.
5. Ulutin HC, Arpaci F, Pak Y. Megestrol acetate for cachexia and anorexia in advanced non-small cell lung cancer:a randomized study comparing two different doses[J]. Tumori, 2002, 88(4):277-280.
6. 刘晓联, 裴显俊, 靳晓玉. 化疗引起疲劳的癌症患者的护理[J]. 国外医学:护理分册, 2000, 19(8):359-360.
7. 南克俊, 魏永长, 李春丽, 等. 甲地孕酮改善晚期恶性肿瘤患者生活质量[J]. 第四军医大学学报, 2002, 23(4):350.
8. Mantovani G, Macciò A, Esu S, et al. Evidence that cisplatin induces serotonin release from human peripheral blood mononuclear cells and that methylprednisolone inhibits this effect[J]. Eur J Cancer, 1996, 32A(11):1983-1985.
9. Ho CM, Ho ST, Wang JJ, et al. Dexamethasone has a central antiemetic mechanism in decerebrated cats[J]. Anesth Analg, 2004, 99(3):734-739.
10. Laviano A, Meguid MM, Rossi-Fanelli F. Cancer anorexia:clinical implications, pathogenesis, and therapeutic strategies[J]. Lancet Oncol, 2003, 4(11):686-694.

West China Medical Journal

醋酸甲地孕酮在肿瘤化学疗法患者中的应用及护理

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