“化疗导致恶心呕吐是小事忍忍就好?”……化疗的这些坑你踩到了吗?

2020-09-06 39健康网 39健康网

要说化疗有多辛苦?没经历过的人肯定不知道。很多人谈到化疗就认为是会吐得不行,并且没办法预防和控制,其实,这都是关于化疗的误区。

要说化疗有多辛苦?没经历过的人肯定不知道。很多人谈到化疗就认为是会吐得不行,并且没办法预防和控制,其实,这都是关于化疗的误区。

中国医学科学院、中国协和医科大学、北京协和医院妇产科肿瘤妇科中心主任兼妇产科学系副主任向阳教授,近日在受访时指出,随着药物的不断研发,现在已经有很好的方法来预防化疗导致的恶心呕吐(CINV)了。

北京协和医院妇科肿瘤中心主任向阳教授(左一)

化疗后吐得不行已经是过去式了,那么现在到底有哪些药物可以预防CINV呢?

根据CINV的发生机制,目前预防CINV的药物主要有两类:一类是通过抑制P物质与NK-1受体结合的NK-1受体拮抗剂(比如:阿瑞匹坦);另一类是通过抑制5-羟色胺和5-HT3受体结合的5-HT3受体拮抗剂。

目前的相关指南均推荐至少含有这两类药物的多药联合方案作为预防高致吐性化疗药物的预防方案。

《中国临床肿瘤学会(CSCO)抗肿瘤治疗相关恶心呕吐预防和治疗指南2019》推荐有高致吐风险的患者使用含NK-1RA(比如:阿瑞匹坦)和5-HT3受体拮抗剂的多药联合方案作为预防CINV的首选方案。中山大学附属肿瘤医院内科主任,肺癌首席专家张力教授在接受采访时介绍道:现在恶心呕吐的完全控制率可以达到70%-80%。

中山大学附属肿瘤医院内科主任张力教授

除了关于CINV的治疗误区,这些有关CINV的误区你也一定要了解。

误区一:化疗导致的恶心呕吐只发生在化疗时吗?

根据发生时间的不同,CINV被分成了5类:

1.急性:通常发生在化疗后的24小时内,大多数患者在5-6小时后才出现;

2.延迟性:通常发生在化疗24小时后至几天之间,常见于顺铂、卡铂、环丙酰胺和阿霉素化疗[1];

3.预期性:通常发生在之前化疗时就已出现过CINV的患者中;

4.爆发性:指即使使用了预防性用药还是出现了恶心呕吐的症状;

5.难治性:在多轮化疗中反复出现恶心呕吐;

因此,预期性呕吐和延迟性呕吐在化疗时通常不会发生,但是有可能在化疗前后发生。

误区二:化疗导致的恶心呕吐是小事忍忍就好

化疗引起的恶心呕吐不仅仅会给患者带来感觉上的痛苦,还可能导致代谢紊乱、机体功能受损、营业不良、切口愈合延迟,甚至还有可能使患者中断或放弃化疗,最终影响患者的生活质量和抗肿瘤治疗效果。

若在化疗之前积极采取预防措施,可以明显降低CINV的发生率。有研究显示,对于接受高致吐风险化疗的人群,呕吐的发生率可降低至30%左右[2]。

随着对化疗副作用和癌症治疗的了解不断深入,越来越多的化疗副作用变得可预防、可控制。尤其是针对化疗导致的恶心呕吐,现在我国已经有很多相关预防药物,只要接受化疗的癌症患者采取正确的预防措施,就能控制好化疗带来的副作用,增强化疗意愿从而提高化疗效果。

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    2021-05-16 荼靡3333333

    谢谢分享

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    2020-09-06 736631716

    学习了,以前化疗时尽量不给药呢

    0

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    2020-09-06 146465bem06暂无昵称

    化疗恶心不容忽视

    0

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    2020-09-06 Mr.d

    学习了

    0

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    2020-09-06 ms6000002001059988

    学习了

    0

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    2020-09-06 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2020-09-06 医鸣惊人

    学习

    0

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