奥沙利铂致外周神经毒性症状特性及变化趋势的纵向研究-论文.pdf

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1、护理学杂志2014年9月第29卷第17期·1··重点关注肿瘤护理专题··论著·奥沙利铂致外周神经毒性症状特性及变化趋势的纵向研究丁彩艳，薛嵋，吴洪斌，陆箴琦摘要：目的探讨肠癌患者使用奥沙利铂期间外周神经毒性症状特性、变化趋势及非药物影响因素。方法对l13例使用奥沙利铂肠癌患者，采用神经毒性患者自述问卷(PNQ)于累积剂量达200mg／m、540mg／m、850mg／m时进行随访调查，评估外周神经毒性症状的严重度；Podo触觉测量笔及温度觉测量笔分别检测患者触觉及温度觉有无异常。结果首次使用奥沙利铂后88．5患者出现肢体感觉异常，首发表现以手部麻木为主，其次为刺痛。不同累积剂量时外周

2、神经毒性严重度比较，差异有统计学意义(均P

3、014)17—0001一O6D0I：i0．3870／hlxzz．2014．17．0O1Longitudinalstudyonoxalip

4、atininducedperipheralneuropathy：symptomfeaturesandchangingpattern／／DingCaiyan，XueMei，WuHongbin，L“Zhenqi／／(DepartmentofNursing，CancerHospitalofFudanUniversity，Shanghai200032，China)Abstract：0bjectiveTodescribesymptomfeatures，ch

5、angingpattern，andnon—pharmacologicalfactorsofoxaliplatininducedpe—ripheralneuropathy．MethodsOnehundredandthirteencolorectalcancerpatientsreceivingoxaliplatin-basedchemotherapywereinvestigatedbyusingthePatientNeurotoxicityQuestionnairewhenthedoseofoxaliplatinwasaccumulatedtO200mg／m，540mg／m。，and

6、850mg／m．TouchandtemperaturesensationweretestedwiththePodotouch—measuringpenandthetemperature—measuringpen．ResultsAbout88．5ofthepatientsexperiencedmeropresthesiaafterreceivingchemotherapyforthefirsttime．Theearlysymptomwasmainlyhandnumbness，followedbytingling．Significantdifferenceswerefoundinsev

7、erityofperipheralneuro—pathyatdifferentaccumulateddosesandinpatientsusingdifferentadministrationmethodswhenthedoseaccumulatedto200rag／mand540mg／m(P<0．05，P<0．O1)．Fourpatientshadimpairedtouchsensation．ConclusionThedamageofsensorynerveismorecommonandseverethanthemotornerveincolorectalcancerpatien

8、tsreceivingoxaliplatin-basedchemotherapy，andthese—verityofneurotoxityisincreasedasthedoseaccumulated．WeshouldprovidetargetededucationandencouragepatientstOreceivemedicationthroughcentra1venouscatheters，SOastoavoidmeropresthesiainearlych