Effect of dolasetron in the prevention and treatment of nausea and vomiting after radical resection of lung cancer

doi:10.3760/cma.j.issn.1007-1245.2023.07.012

Abstract

Abstract:

Objective　To observe the effect of dolasetron in the prevention and treatment of nausea and vomiting after radical resection of lung cancer and explore its mechanism. Methods　It was a randomized controlled trial. A total of 125 patients with lung cancer who received radical surgery in The First People's Hospital of Shangqiu City from May 2019 to August 2021 were selected as subjects, and were randomly divided into a treatment group (63 cases) and a conventional group (62 cases) by drawing lots. In the treatment group, 40 males and 23 females, aged (55.25±5.15) years, were treated with dolasetron for prevention of postoperative nausea and vomiting. In the conventional group, 42 males and 20 females, aged (55.46±5.23) years, were treated with conventional antiemetic measures. The frequencies of vomiting, Index of Nausea and Vomiting and Retching (INVR) scores, and Kolcaba General Comfort Questionnaire (GCQ) scores 6, 12, 24, and 48 h after surgery, and severity of vomiting symptoms were compared between the two groups. Long-term follow-up was conducted for 1 year after surgery to compare the survival of the two groups. χ² test and t test were used. Results　Six, 12, 24, and 48 h after surgery, the frequencies of vomiting [3.17% (2/63), 4.76% (3/63), 3.17% (2/63), and 0.00% (0/63)] and INVR scores [(20.25±5.41) points, (17.24±3.31) points, (15.25±2.33) points, and (13.11±1.25) points] in the treatment group were lower than that in the conventional group [16.13% (10/62), 17.74% (11/62), 14.52% (9/62), 8.06% (5/62), (23.58±5.86) points, (20.55±3.81) points, (16.83±2.88) points, and (14.92±1.86) points], while the GCQ scores [(73.85±5.83) points, (75.72±3.82) points, (80.75±2.81) points, and (85.88±1.86) points] were higher than those in the conventional group [(70.52±5.31) points, (72.41±3.16) points, (79.39±2.25) points, and (81.52±1.32) points], with statistically significant differences (all P<0.05). The rate of nausea and vomiting in the treatment group was lower than that in the conventional group [11.11% (7/63) vs. 53.23% (33/62)], with a statistically significant difference (χ²=25.470, P<0.001). During the follow-up period, the KPS score [(73.35±5.17) points] and QOL score [(43.71±5.85) points] in the treatment group were higher than those in the conventional group [(70.66±5.28) points and (40.25±5.62) points], while the ZPS score [(2.55±0.33) points] was lower than that of the conventional group [(2.92±0.85) points], with statistically significant differences (all P<0.05). Conclusions　Using dolasetron to pretreat lung cancer patients before anesthesia induction during radical surgery can effectively reduce the risk of postoperative nausea and vomiting, and has a positive effect on improving postoperative symptoms and improving patients' comfort and long-term quality of life. The mechanism of action is reflected in the central and peripheral vagal neurotransmitter receptor blocking.

Key words:

Radical resection of lung cancer, Postoperative nausea and vomiting, Dolasetron, Control effect, Quality of life

摘要：

目的　观察多拉司琼对肺癌根治术后恶心呕吐的防治效果及作用机制。方法　本文为随机对照试验。选取2019年5月至2021年8月商丘市第一人民医院行根治术治疗的肺癌患者125例为研究对象，采用抽签法将患者随机分为治疗组（63例）和常规组（62例）。治疗组男40例、女23例，年龄（55.25±5.15）岁，采用多拉司琼防治术后恶心呕吐；常规组男42例、女20例，年龄（55.46±5.23）岁，实施常规止吐措施治疗。比较两组患者术后6 h、12 h、24 h、48 h呕吐频率、恶心呕吐干呕症状评估量表（INVR）评分、Kolcaba舒适状况量表（GCQ）评分以及呕吐症状严重程度，术后开展为期1年远期随访，对比两组患者生存情况。采用χ²检验、t检验。结果　术后6 h、12 h、24 h、48 h，治疗组呕吐频率［3.17%（2/63）、4.76%（3/63）、3.17%（2/63）、0.00%（0/63）］及INVR评分［（20.25±5.41）分、（17.24±3.31）分、（15.25±2.33）分、（13.11±1.25）分］均低于常规组［16.13%（10/62）、17.74%（11/62）、14.52%（9/62）、8.06%（5/62）及（23.58±5.86）分、（20.55±3.81）分、（16.83±2.88）分、（14.92±1.86）分］，GCQ评分［（73.85±5.83）分、（75.72±3.82）分、（80.75±2.81）分、（85.88±1.86）分］均高于常规组［（70.52±5.31）分、（72.41±3.16）分、（79.39±2.25）分、（81.52±1.32）分］，差异均有统计学意义（均P<0.05）。治疗组恶心呕吐比例［11.11%（7/63）］低于常规组［53.23%（33/62）］，差异有统计学意义（χ²=25.470，P<0.001）。随访期间，治疗组功能状态（KPS）评分［（73.35±5.17）分］、生活质量（QOL）评分［（43.71±5.85）分］均高于常规组［（70.66±5.28）分、（40.25±5.62）分］，体力状况（ZPS）评分［（2.55±0.33）分］低于常规组［（2.92±0.85）分］，差异均有统计学意义（均P<0.05）。结论　在肺癌根治术麻醉诱导前采用多拉司琼进行预处理可有效降低术后恶心呕吐发生风险，对促进患者术后相关症状改善、提升患者舒适度及远期生存质量均有积极作用，其作用机制体现在对中枢、外周迷走神经递质受体阻断方面。

关键词:

肺癌根治术, 术后恶心呕吐, 多拉司琼, 防治效果, 生存质量

Liu Yunhui, Yang Qiumin, Lin Chunli.

Effect of dolasetron in the prevention and treatment of nausea and vomiting after radical resection of lung cancer [J]. International Medicine and Health Guidance News, 2023, 29(7): 940-943.

刘运慧杨秋敏林春丽.

多拉司琼对肺癌根治术后恶心呕吐的效果 [J]. 国际医药卫生导报, 2023, 29(7): 940-943.

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