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[一项使用奥曲肽缓解晚期癌症患者肠梗阻所致胃肠道症状的临床研究]

[A clinical study using octreotide in relieving gastrointestinal symptoms due to bowel obstruction in a terminally ill cancer patient].

作者信息

Shima Yasuo, Yamaguchi Kensei, Miyata Yoshinori, Hyodo Ichinosuke, Yagi Yasuo, Honke Yoshifumi

机构信息

Palliative Care Unit, National Cancer Center Hospital East.

出版信息

Gan To Kagaku Ryoho. 2004 Sep;31(9):1377-82.

Abstract

Terminally ill cancer patients with complicated bowel obstructions often have poor quality of life (QOL) due to gastrointestinal symptoms such as nausea and vomiting. Many of these patients are inoperable because of poor general conditions, and half of these patients can't be managed by conventional antiemetics. There are many reports indicating octreotide is effective for these patients. In the present study, 13 patients (5 patients without a nasogastric tube and 8 patients with) were administered octreotide at 300 microg/day by 24 hours continuous subcutaneous infusion. Among the effectively evaluable 10 cases, 6 cases (60.0%) were assessed as effective according to the efficacy criteria based on the JCOG toxicity scale. In the 6 cases who had nasogastric tubes, the nasogastric aspirates decreased from 890 ml (550-1,950) to 480 ml (180-1,790). Vomiting was successfully controlled after the removals of nasogastric tubes in 4 out of 6 cases (66.7%), regarding safety, 2 out of 13 cases (15.4%) showed an excess of liver enzymes but no clinically suspected adverse effect was observed. Octreotide is effective and well tolerated in terminally ill cancer patients with malignant bowel obstruction.

摘要

患有复杂肠梗阻的晚期癌症患者常因恶心、呕吐等胃肠道症状而生活质量较差。这些患者中的许多人因全身状况不佳而无法进行手术,并且其中一半的患者无法通过传统的止吐药进行治疗。有许多报告表明奥曲肽对这些患者有效。在本研究中,13例患者(5例未插鼻胃管,8例插了鼻胃管)通过24小时持续皮下输注给予奥曲肽,剂量为300微克/天。在10例可有效评估的病例中,根据基于日本临床肿瘤学会毒性量表的疗效标准,6例(60.0%)被评估为有效。在6例插了鼻胃管的病例中,鼻胃管吸出量从890毫升(550 - 1950)降至480毫升(180 - 1790)。6例中有4例(66.7%)在拔除鼻胃管后呕吐得到成功控制。关于安全性,13例中有2例(15.4%)出现肝酶升高,但未观察到临床上可疑的不良反应。奥曲肽对患有恶性肠梗阻的晚期癌症患者有效且耐受性良好。

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