化疗相关性恶心呕吐_cinv_的药物防治及指南指导下的临床实践_陈歆妮.pdfVIP

临床药物治疗杂志 2014 年 9 月第 12 卷第 5 期 Clinical Medication Journal,Sep.2014,Vol.12,No.5 ·综述· 化疗相关性恶心呕吐 （CINV ）的药物防治及指南 指导下的临床实践 * 陈歆妮 陈映霞 秦叔逵 解放军八一医院全军肿瘤中心肿瘤内科 （南京 2 10002 ） 【摘要】 目的：探讨化疗相关性恶心呕吐 （CINV ）的规范化处理的临床意义。方法：回顾近 年CINV 处理理念的发展, 比较各国CINV 指南的异同, 以及临床实践遵循指南的情况。结果：各 国CINV 指南均主张预防为主，按分级、分时段、联合的原则进行个体化处理。遵循指南有临床获益， 但目前执行力度不够。结论：加强CINV 指南的推广为当务之急。 【关键词】恶性肿瘤; 化疗相关性恶心呕吐; 处理; 指南 【中图分类号】R978.7 【文献标志码】A doi:10.3969/j .issn.1672-3384.2014.05.002 Treatment of Chemotherapy-induced Nausea and Vomiting (CINV) Based on Guidelines CHEN Xin-ni, CHEN Ying-xia*, QIN Shu-kui. Department of Medical Oncology, PLA Cancer Center, 81 Hospital of PLA, Nanj ing 2 10002, China Abstract Objective: To explore the clinical significance of the standardized treatment on CINV. 【 】 Methods: We reviewed development of the ideas of CINV processing for the last few years, compared the similarities and differences of various CINV guidelines, and also inspectedthe circumstances of compliance with guidelines.Results: All CINV guidelines in different countries putted the prevention first and advocated the individualized treatment based on principles of classification, dayparting and combination. These guidelines offered clinical benefits for cancer patients with CINV, while there was no enough enforcement in practice presently.Conclusion: It is imperative to strengthen the promotion of CINV guidelines. Keywords malignant tumor; cheomtherapy-induced nausea and vomiting; management; guideline 【 】 化疗药物引起的恶心和呕吐是一种常见且令 中 致 吐 风 险（MEC，30%~90%）、 低致吐风险 人畏惧的伴随症状，称为化疗相关性恶心呕吐 （10%~30%）和极低致吐风险（10%）。CINV （chemotherapy-induced nausea and vomiting, 发生还受到患者个体差异的影响，如年轻（年龄 CINV）。CINV 往往导致患者化疗依从性下降， 低于 55 岁，OR =