对256例服用吉非替尼非小细胞肺癌患者的药学监护体会

彭静

[摘要] 目的 探讨对256例服用吉非替尼非小细胞肺癌患者实施药学监护的过程、方法及其作用。 方法 选取2017年10月至2019年10月在我院肿瘤科住院的服用吉非替尼的非小细胞肺癌患者256例，对照组给予常规药物治疗，观察组在药物治疗基础上给予针对性药学监护措施，对其不良反应相应给予不同的应对方案，整理、归纳和分析两组的治疗总有效率、不良反应总发生率和因不良反应导致的总停药率。 结果 观察组的治疗总有效率为48.44%，明显高于对照组的28.12%，差异有统计学意义（P<0.05）;两组不良反应总发生率比较，差异无统计学意义（P>0.05）;观察组因不良反应导致的总停药率为25.78%，明显低于对照组的40.63%，差异有统计学意义（P<0.05）。 结论 通过对吉非替尼不良反应的针对性药学监护，使其疗效显著升高、停药率显著降低，大大提高了患者的依从性。

[关键词] 吉非替尼;非小细胞肺癌;不良反应;药学监护

[Abstract] Objective To explore the process， method and effect of pharmacological monitoring on 256 non-small cell lung cancer patients taking gefitinib. Methods A total of 256 non-small cell lung cancer patients taking gefitinib who were admitted to the oncology department of our hospital from October 2017 to October 2019 were selected. The control group was given conventional drug treatment. The observation group was given targeted pharmaceutical monitoring measures on the basis of conventional drug treatment. Different countermeasures were given for corresponding adverse reactions. The total effective rate， incidence of total adverse reactions， and the total discontinuation rates due to adverse reactions were sorted out， summarized， and analyzed in the two groups. Results The total effective rate of treatment in the observation group （48.44%） was significantly higher than that of the control group （28.12%）， and the difference was statistically significant （P<0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups （P>0.05）. The total discontinuation rate of the observation group （25.78%） due to the occurrence of adverse reactions was significantly lower than that of the control group（40.63%）， and the difference was statistically significant（P<0.05）. Conclusion Through targeted pharmacological monitoring of adverse reactions to gefitinib， the efficacy of treatment was significantly improved， the rate of withdrawal was significantly reduced， and the patient compliance was greatly improved.

[Key words] Gefitinib; Non-small cell lung cancer; Adverse reactions; Pharmaceutical monitoring

非小細胞肺癌（Non-small cell lung cancer，NSCLC）的主要治疗手段是全身化疗和局部放疗，但只能暂时延长患者的生存时间，不能明显提高其生存质量。而且放疗、化疗对人体正常的细胞也有损害，会引起剧烈呕吐、骨髓抑制等，使患者机体免疫功能下降，不能耐受，最终无法控制肿瘤的广泛转移[1]。目前，科学家的研究重点从化疗药物转向靶向药物，靶向药物是针对肿瘤细胞的恶性表型分子实行针对性治疗，在目标部位蓄积或释放有效成分，其作用更精准、治疗效果更好。吉非替尼是第一个被美国食品药品监督管理局（Food and drug administration，FDA）批准的表皮生长因子受体酪氨酸激酶抑制剂（Epidermal growth factor receptor-tyrosine kinase inhibitor，EGFR-TKI），其通过抑制信号传导途径而阻碍肿瘤细胞的存活、转移和血管生成，目前临床上广泛用于治疗既往接受过化学治疗的局部晚期或转移性NSCLC患者。……