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1、论著•原始研究中国循证医学杂志2013,13(6):687～691肿瘤化疗所致恶心呕吐现状调查董爽于世英*华中科技大学同济医学院附属同济医院（武汉430030）摘要目的调查化疗所致恶心呕吐（chemotherapy-inducednauseaandvomiting，CINV）的患者心理预期和发生情况，并评估CINV对患者生活质量的影响，为提高临床医生对CINV的认识和重视提供依据。方法采用问卷调查的方式，调查华中科技大学同济医学院附属同济医院使用中度致吐风险化疗（MEC）或高度致吐风险化疗（HEC）的患者，并对其进行连续两周期相同化疗方案的随
2、访。患者分别于化疗开始前、化疗第2天和化疗第6天，记录化疗期间急性、延迟性恶心呕吐发生情况、自主止吐用药和CINV对生活功能的影响，调查结果采用描述性分析和多元线性回归分析。结果本研究共调查344例患者，最终303例患者完成问卷调查。结果显示：单日化疗MEC组急性、延迟性和总的完全缓解率分别为86.1%、76.6%和71.5%，HEC组为84.1%、71.0%和66.7%。多日化疗患者分别为93.8%、64.9%和64.9%；第2周期化疗前患者关于恶心呕吐预期值和焦虑值与患者前一周期化疗延迟性恶心发生的严重程度密切相关；约30%的患者因CIN
3、V对生活功能造成负面影响。结论在行中度和高度致吐风险化疗的患者中，CINV治疗现状仍存在较大问题，尤其是在延迟期反应和恶心症状的控制方面。在临床实践中需进一步加强对CINV的关注，并提供更加有效的治疗措施。关键词化疗所致恶心呕吐；中度致吐风险化疗；高度致吐风险化疗；生活功能；调查StatusSurveyonChemotherapy-InducedNauseaandVomitingDONGShuang,YUShi-ying*TongjiHospitalAffiliatedtoTongjiMedicalCollegeofHuazhongUnive
4、rsityofScienceandTechnology,Wuhan430030,ChinaAbstractObjectiveToinvestigatethepatient’spsychologicalanticipationandoccurrenceofchemotherapy-inducednauseaandvomiting(CINV),andtoassesstheinfluenceofCINVonqualityoflife,soastoprovideevidenceforclinicaldoctorstorecognizeandpayat
5、tentiontoCINV.MethodsThepatientsintheTongjiHospitalaffiliatedtoTongjiMedicalCollegeofHuazhongUniversityofScienceandTechnologywhotookeithermoderatelyemetogenicchemo-therapy(MEC)orhighlyemetogenicchemotherapy(HEC)wererandomlysampledwithaquestionnairefortwocircles.Patientswere
6、askedtorecordthefollowingindexesbeforechemotherapy,ontheseconddayandthesixthdayofchemo-therapy:acuteanddelayednauseaandvomiting,independentlytakingantiemetics,andfunctionallivingindex-emesis(FLIE).Then,descriptiveanalysisandmultiplelinearregressionanalysiswereadoptedfortheo
7、utcomesofinvestigation.ResultsAtotalof344patientswereinvestigated,ofwhich303fulfilledthequestionnairefinally.Forthesingle-daychemotherapy,theacutenauseaandvomiting,delayednauseavomitingandoverallcompleteremissionintheMECgroupwere86.1%,76.6%,and71.5%,respectively;whilethoseo
8、ftheHECgroupwere84.1%,71.0%,and66.7%,respectively.Forthemulti-daychemotherapy,thea
