文章摘要
钱小军,陈健,潘跃银,等.胃癌根治术后辅助化疗期间血红蛋白下降的相关因素分析[J].安徽医药,2020,24(8):1525-1529.
胃癌根治术后辅助化疗期间血红蛋白下降的相关因素分析
Analysis of related factors of postgastrectomy hemoglobin decline in adjuvant chemotherapy
  
DOI:10.3969/j.issn.1009?6469.2020.08.011
中文关键词: 贫血,低色素性  胃肿瘤  胃切除术后综合征  辅助化疗  高危因素
英文关键词: Anemia,hypochromic  Stomach neoplasms  Postgastrectomy syndromes  Adjuvant chemotherapy  High risk factors
基金项目:安徽省自然科学基金,联合基金(WK9110000009,WK9110000067)(1608085QH190)“科大新医学”
作者单位
钱小军 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
陈健 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
潘跃银 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
王刚 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
孙玉蓓 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
陈曼萍 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
郑海燕 中国科学技术大学附属第一医院安徽省立医院肿瘤内科安徽合肥 230001 
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中文摘要:
      目的分析胃癌根治术后接受辅助化疗期间,病人血红蛋白下降的影响因素。方法收集中国科学技术大学附属第一医院 2015年 1月至 2017年 1月接受铂类 /紫杉类联合氟脲嘧啶类方案辅助化疗的 102例胃癌病人的资料,分析病人临床病理特征与辅助化疗期间血红蛋白下降的相关性。结果 64例(62.7%)病人术后存在贫血, 79例(77.4%)病人辅助化疗期间存在贫血。接受辅助化疗的病人中, 70例(68.6%)血红蛋白下降 1 mg/L及以上, 17例(16.6%)发生 Ⅲ~Ⅳ级化疗不良反应, 7例(6.8%)因不良反应调整化疗剂量及方案。单因素分析结果显示,肿瘤浸润深度为 T4的病人血红蛋白下降至少 1 mg/L以及 2 mg/L的发生率明显高于 T1?3的病人(P<0.05)。多因素分析结果显示,术中出血量> 100 mL、化疗前存在贫血、白蛋白低于正常值的病人,血红蛋白下降 1 mg/L及以上的发生率明显高于对照组(P<0.05)。结论胃癌根治术后 T4、术中出血大于 100 mL、化疗前贫血、低蛋白血症是影响辅助化疗引起血红蛋白下降的高危因素。
英文摘要:
      Objective To explore the influencing factors of hemoglobin decline during adjuvant chemotherapy after radical gastrec? tomy.Methods One hundred and two gastric cancer patients who received adjuvant chemotherapy with platinum or paclitaxel withfluorouracil regimen from January 2015 to January 2017 in the First Hospital of University of Science and Technology of Chinawere collected,and the correlation between the clinical pathological characteristics and adjuvant chemotherapy were analyzed.Re? sults Among them,64 patients(62.7%)had anemia after surgery,79 patients(77.4%)had anemia during chemotherapy.Among the patients who received adjuvant chemotherapy,70 patients(68.6%)had a further decrease in hemoglobin at least 1 mg/L,17 pa? tients(16.6%)developed grade Ⅲ?Ⅳ adverse reactions,and 7 patients(6.8%)had the chemotherapy dose or regimena djustmentdue to adverse reactions.Univariate analysis revealed that hemoglobin in patients with stage T4 tumor decreased by at least 1 mg/L or 2 mg/L and the incidence was significantly higher than that in patients with T1?3(P<0.05).Multivariate analysis revealed that patients with more than 100 mL operational bleeding,pre?chemotherapy anemia,albumin below normal,and the incidence of hemo? globin reduction of at least 1 mg/L,the incidence was significantly higher than those of control group(P<0.05).Conclusion Gas? tric cancer patients with stage T4,more than 100 mL operational bleeding,pre?chemotherapy anemiaor hypoproteinemia are high?risk factors that affect the decrease in hemoglobin caused by adjuvant chemotherapy.
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