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结直肠癌患者奥沙利铂化疗致外周神经毒性单因素分析及其防治策略

Univariate analysis of peripheral neurotoxicity induced by oxaliplatin chemotherapy in patients with colorectal cancer and its prevention and treatment strategies

摘要目的:分析奥沙利铂治疗结直肠癌患者所致神经毒性的相关因素并探讨应对策略。方法:采用方便抽样的方法,选取2018年1月至2020年12月浙江省肿瘤医院收治的结直肠癌且使用奥沙利铂化疗的患者300例进行基线调查,统计患者外周神经毒性(OIPN)发生情况,采用单因素分析奥沙利铂致患者OIPN的影响因素。结果:患者OIPN评分在性别、学历、职业、长期居住地差异均有统计学意义( t=7.29、3.39、2.53、18.11,均 P < 0.05);而在宗教、婚姻、同住成员、医疗付费、是否有吸烟史因素,得分差异均无统计学意义( t=3.25、0.37、0.69、2.39、0.15,均 P > 0.05)。而患者的疾病资料中,肿瘤TNM分期、不同静脉通路、奥沙利铂累积量,差异均有统计学意义( t=8.40、3.34、3.49,均 P < 0.05)。 结论:医务人员需重视结直肠癌使用奥沙利铂治疗患者OIPN的发生情况,关注患者自身与疾病相关因素,及时采取正确的有效的应对策略,以减轻患者不良反应,改善生活质量,确保治疗效果。

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abstractsObjective:To analyze the related factors of neurotoxicity induced by oxaliplatin chemotherapy in patients with colorectal cancer and its prevention and treatment strategies.Methods:A total of 300 patients with colorectal cancer treated with oxaliplatin in Zhejiang Cancer Hospital from January 2018 to December 2020 were randomly selected for baseline collection using the convenience sampling method. The occurrence of oxaliplatin-induced peripheral neurotoxicity (OIPN) was statistically analyzed. The factors that affect the occurrence of OIPN were analyzed using univariate analysis.Results:There was a significant difference in OIPN score between patients of different genders, between patients who had different education levels, between patients who had different occupations, and between patients who lived in different long-term residence places ( t = 7.29, 3.39, 2.53, 18.11, all P < 0.05). There was no significant difference in OIPN score between patients adhering to different religion's beliefs, between patients married and not, between patients who lived with and without members, between patients who paid medical costs and not, and between patients who had a previous history of smoking and not ( t = 3.25, 0.37, 0.69, 2.39, 0.15, all P > 0.05). There was a significant difference in OIPN score between patients with different tumor-node-metastasis stages, between patients who received medication via different administration routes, and between patients who received different times of oxaliplatin administration ( t = 8.40, 3.34, 3.49, all P < 0.05). Conclusion:Medical staff should pay attention to the occurrence of OIPN in patients with colorectal cancer treated with oxaliplatin, focus on the patient's factors related to the disease, and take correct and effective coping strategies promptly to reduce the adverse reactions, improve the quality of life, and ensure the therapeutic effect.

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