田瑞华　郑宗柱　陈祥明　李宝江

[摘要] 目的 观察奥氮平在乳腺癌新辅助化疗中的止吐疗效。 方法 方便选取2014年9月—2016年4月该院采用CET新辅助化疗的乳腺癌患者100例，随机分为两组，各50例。两组均帕洛诺司琼、地塞米松止吐，观察组同时加用奥氮平止吐。比较两组控制急性和延迟性恶心、呕吐的疗效、不良反应，及化疗前后的体重变化。结果 观察组急性、延迟性恶心、呕吐控制有效率分别为92%，76%，均高于对照组的74%，54%，差异有统计学意义（P<0.05）。观察组体重变化有效率32%，比对照组有效率22%高，但两组差异无统计学意义（P>0.05）。两组不良反应均较轻微。结论 奥氮平提高了乳腺癌新辅助化疗止吐疗效。

[关键词] 奥氮平；乳腺癌；新辅助化疗；止吐

[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-0742（2017）08（a）-0118-03

[Abstracts] Objective This paper tries to explore the antiemetic efficacy of olanzapine in breast cancer neoadjuvant chemotherapy. Methods 100 breast cancer patients from September 2014 to April 2016 received CET neoadjuvant chemotherapy were convenient selected and randomly divided into two groups with 50 cases in each group. The two groups were all given palonosetron and dexamethasone， and the observation group was combined with olanzapine simultaneously， to prevent nausea and vomiting. The remission effect and adverse reactions of the two groups in the control of acute and delayed nausea and vomiting， and the changes of body weight before and after chemotherapy were compared. Results In acute and delay nausea and vomiting period， the remission rate in the observation group were 92% and 76%， obviously higher than that in control group of 74% and 54%， the differences were statistically significant （P<0.05）. The weight change rate of the observation group was 32%， higher than that of the control group of 22%， but the difference was no statistically significant （P>0.05）. The adverse reactions of the two groups were few. Conclusion Antiemetic therapy containing olanzapine can increase the antiemetic efficacy in breast cancer neoadjuvant chemotherapy.

[Key words] Olanzapine； Breast cancer； Neoadjuvant chemotherapy； Antiemetic

乳腺癌已成为我国女性发病第一位的恶性肿瘤，发病率并逐年上升。目前新辅助化疗已成为局部进展期乳腺癌的标准治疗方案和可手术切除乳腺癌的标准治疗选择之一。但化疗所致的恶心、呕吐（chemotherapy induced nausea and vomiting，CINV）等消化道反应严重影响患者的生活质量，也是导致患者恐惧化疗、依从性降低的主要因素之一[1]，甚至延误手术治療。2014版中国肿瘤治疗相关呕吐防治指南推荐：高致吐风险药物化疗的患者，三联止吐方案：5-HT3受体拮抗剂、地塞米松联合NK-1受体拮抗剂（阿瑞吡坦等）作为目前化疗止吐的一线治疗方案[2]。但NK-1受体拮抗剂在国内上市时间短，价格昂贵，在应用中受到限制。因此，临床上急需探讨一种高效、低毒、经济适用的止吐方案。方便收集该院2014年9月—2016年4月新辅助化疗的乳腺癌患者100例，并观察奥氮平联合止吐疗效及不良反应，现报道如下。……