Ono Chiemi, Yamagami Mitsue, Kamatani Rika, Yamamoto Makoto, Mukouyama Tomoya, Sugimoto Masakazu, Suzuki Taizan, Kamo Nobuyuki, Seki Nobuhiko, Eguchi Kenji, Ikeda Tadashi
Department of Nursing, Teikyo University Hospital.
Gan To Kagaku Ryoho. 2012 May;39(5):777-81.
Epirubicin hydrochloride(EPI)is well known to cause phlebitis as a typical adverse drug reaction. By preventing the development of severe phlebitis, patients are expected to continue effective chemotherapy with EPI without a decrease in QOL. We have previously reported promising results of a new injection method to prevent phlebitis from occurring during EPI therapy thorough a prospective clinical trial in our hospital(Jpn J Cancer Chemother 36: 969-974, 2009). In the present study, we have compared the conventional injection method(EPI main -route method, n=15)with our new method, which has been consistently practiced at present(EPI sub -route method, n=77). We found that in the EPI main -route method, angialgia/phlebitis developed in 14 of 15 cases(Grade 3, 53. 3%), leading to alteration of the regimen in 3 cases. On the other hand, with the EPI sub -route method, incidence of angialgia/phlebitis was markedly decreased, and only 6 of 77 cases developed these adverse reactions(Grade 3, 0%). One possible explanation for these results is that the reduction of intimal stimulation by the EPI sub -route method might be caused by the dilution and washout of EPI with pre-medication, as well as the shortened infusion times of EPI. Therefore, on the basis of the above hypothesis, we conclude that the EPI sub-route method might be a more effective treatment for the expected prevention of angialgia/phlebitis.
众所周知,盐酸表柔比星(EPI)作为一种典型的药物不良反应可引起静脉炎。通过预防严重静脉炎的发生,有望使患者能够继续接受EPI有效化疗而不降低生活质量。我们之前通过我院的一项前瞻性临床试验报道了一种新的注射方法在预防EPI治疗期间发生静脉炎方面取得了有前景的结果(《日本癌症化疗杂志》36: 969 - 974, 2009)。在本研究中,我们将传统注射方法(EPI主路径法,n = 15)与我们目前一直采用的新方法(EPI次路径法,n = 77)进行了比较。我们发现,在EPI主路径法中,15例中有14例发生血管痛/静脉炎(3级,53.3%),导致3例治疗方案改变。另一方面,采用EPI次路径法时,血管痛/静脉炎的发生率显著降低,77例中只有6例出现这些不良反应(3级,0%)。对这些结果的一种可能解释是,EPI次路径法对内膜刺激的减少可能是由于预处理对EPI的稀释和冲洗,以及EPI输注时间的缩短。因此,基于上述假设,我们得出结论,EPI次路径法可能是预防血管痛/静脉炎更有效的治疗方法。