目的 探討帕洛諾司瓊不同給藥頻次預(yù)防大劑量順鉑化療致胃腸道反應(yīng)的臨床療效。方法 上海市奉賢區(qū)中心醫(yī)院2010年4月—2014年1月收治的行大劑量順鉑化療的惡性腫瘤患者，隨機(jī)分為對(duì)照組（42例）和治療組（42例）。對(duì)照組化療第1天治療前30 min靜脈點(diǎn)滴鹽酸帕洛諾司瓊注射液0.25 mg/次；治療組于化療第1、3、5天治療前30 min靜脈點(diǎn)滴鹽酸帕洛諾司瓊注射液0.25 mg/次。所有患者僅觀察1個(gè)化療周期。比較兩組患者嘔吐、惡心、食欲減退的發(fā)生情況。結(jié)果 對(duì)照組急性期嘔吐有效控制率為78.57%，治療組為83.33%，兩組比較差異無統(tǒng)計(jì)學(xué)意義；延遲期對(duì)照組嘔吐有效控制率為52.38%，治療組為61.90%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。治療后，急性期對(duì)照組惡心有效率為61.90%；治療組有效率為76.19%；延遲期對(duì)照組惡心有效率為52.38%，治療組為66.67%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.01）。急性期對(duì)照組食欲減退有效控制率為88.10%，治療組為92.86%；延遲期對(duì)照組有效控制率為85.71%，治療組為90.48%，兩組比較差異無統(tǒng)計(jì)學(xué)意義。兩組不良反應(yīng)發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 對(duì)大劑量順鉑化療致胃腸道反應(yīng)可適當(dāng)增加鹽酸帕洛諾司瓊用藥頻次進(jìn)行預(yù)防，但應(yīng)警惕增加不良反應(yīng)的風(fēng)險(xiǎn)。

objective To observe the clinical effects on various frequency of palonosetron for preventing gastrointestinal adverse reaction induced by high-dosage cisplatin chemotherapy. Methods The patients (84 cases) diagnosed as malignant tumor who were accepted high-dosage cisplatin chemotherapy in Shanghai Fengxian District Central Hospital from April 2010 to January 2014 were randomly divided into treatment (42 cases) and control (42 cases) groups. Patients in the control group were iv administered with Palonosetron Injection 0.25 mg/time 30 min before the treatment on day 1 of chemotherapy. Patients in the treatment group were iv administered with Palonosetron Injection 0.25 mg/time 30 min before the treatment on days 1, 3, and 5 of chemotherapy. All the patients were observed for one cycle of chemotherapy. Occurrence situations of vomiting, nausea, and loss of appetite were compared. Results In the acute phase, vomiting control efficiency in the control group was 78.57% and 83.33% in the treatment group, while the difference was no statistically significant between the two groups. In the delay phase, vomiting control efficiency in the control group was 52.38% and 61.90% in the treatment group, with the significant difference between the two groups (P < 0.01). After the treatment, in the acute phase, the nausea efficiency in the control group was 61.90% and 76.19% in the treatment group. In delay phase, the nausea efficiency in the control group was 52.38% and 66.67% in the treatment group, with the significant difference between the two groups (P < 0.01). In the acute phase, the loss of appetite control efficiency in the control group was 88.10% and 92.86% in the treatment group. In the delay phase, the loss of appetite control efficiency in control group was 85.71% and 90.48% in the treatment group, while the difference was no statistically significant between the two groups. Conclusion The frequency of palonosetron could be appropriately increased for preventing gastrointestinal adverse reaction induced by high-dosage cisplatin chemotherapy, but the increased risk of adverse reactions should be alerted.