替吉奥胶囊对老年晚期胃癌患者的不良反应评价及其用药护理

仇丽丽+佀双双+张欢

[摘要] 目的 探討替吉奥胶囊对老年晚期胃癌患者的不良反应，并归纳其用药护理方法。 方法 选择老年晚期胃癌患者56例作为本次研究对象，均采用替吉奥进行治疗，给药剂量为40～60mg/次，早晚两次，口服给药，连续给药治疗4周后休息2周，每6周为一个周期，治疗持续1～4个周期。从开始用药后即观察患者不良反应发生情况，并给予饮食、用药及心理护理干预指导。 结果 替吉奥胶囊对老年晚期胃癌患者的治疗有效率为85.71%；治疗后患者KPS评分明显提高，差异有统计学意义（P<0.05）；48例患者出现不同程度的毒副反应：消化道不良反应35例；血液毒性（骨髓抑制）反应19例；皮肤毒性反应41例；谷丙转氨酶升高21例，毒副反应多分布于Ⅰ～Ⅱ度。 结论 替吉奥胶囊具有良好的临床疗效，但存在相应毒副反应，故治疗期间医护人员需注意给予相应护理干预，保证治疗按计划进行。

[关键词] 替吉奥；晚期胃癌；不良反应；用药护理

[中图分类号] R473.73 [文献标识码] A [文章编号] 2095-0616（2017）20-42-04

Evaluation of adverse effects of gimeracil and oteracil porassium capsules on elderly patients with advanced gastric cancer and medication nursing

QIU Lili1 SI Shuangshuang2 ZHANG Huan1

1.Department of Gastroenterology，Hongqi Hospital Affiliated to Mudanjiang Medical University，Mudanjiang 157000，China；2.Department of Nephrology，Hongqi Hospital Affiliated to Mudanjiang Medical University，Mudanjiang 157000，China

[Abstract] Objective To investigate the adverse effects of Tegafur Gimeracil Oteracil Potassium Capsule on elderly patients with advanced gastric cancer and to summarize medication nursing methods. Methods 56 elderly patients with advanced gastric cancer were selected as the subjects.Patients were treated with Gimeracil and Oteracil Porassium.The dosage was 40-60mg/times，two times sooner or later，orally administered.After 4 weeks of continuous treatment，the interval was 2 weeks，one cycle every 6 weeks，and the treatment lasted for 1-4 cycles.The occurrence of adverse reactions in patients from the beginning of the medication were observed.And diet，medication and psychological nursing intervention guidance were given. Results The effective rate of Tegafur Gimeracil Oteracil Potassium Capsule for the patients with advanced gastric cancer was 85.71%.After treatment，KPS score was significantly improved，and the difference was statistically significant （P<0.05）；48 patients suffered from varying degrees of toxic and side effects，including 35 cases of adverse reactions of digestive tract；blood toxicity （myelosuppression） reaction in 19 cases；41 cases of skin toxicity；21 patients with elevated alanine aminotransferase，toxicities were distributed in I-II degree. Conclusion Tegafur Gimeracil Oteracil Potassium Capsule has good clinical efficacy，but it has corresponding adverse reactions，so the medical staff should pay attention to the corresponding nursing intervention during the treatment period to ensure that the treatment is carried out according to plan.endprint

[Key words] Tegafur Gimeracil Oteracil Potassium；Advanced gastric cancer；Adverse reactions；Medication care

胃癌是源于胃上皮细胞的恶性肿瘤，虽然近年来在全球的总发病率有所下降，但其具有明显的地域性，在发展中国家，尤其是中国及其他东亚国家仍呈高发状态，是我国最常见的恶性肿瘤之一[1]。

化学治疗是晚期胃癌的主要治疗手段，替吉奥胶囊是5-氟尿嘧啶衍生物替加氟（FT）和生化修饰剂吉美嘧啶（CDHP）、奥特拉西（Oxo）共同组成的口服抗癌制剂，具有给药方便、能维持较高血药浓度、消化道毒性反应低的优点[2]。老年患者通常合并多种基础疾病，功能状态相对不理想，多数患者只能耐受一种药物，故本次研究采用替吉奥单药治疗。由于给药方便，患者常在家自行服用，而患者及其家属常缺乏正确、科学的护理知识，患者出现不良反应症状时不能及时处理，造成不良影响，延误治疗，甚至危及生命[3]。……