【摘要】 目的： 探讨妇科肿瘤患者化疗后骨髓抑制的预防。方法： 对272例妇科肿瘤患者化疗前的临床症状、血象及KPS评分等临床资料进行回顾性分析。结果： 骨髓抑制发生的相关危险因素有化疗前KPS评分≤60分、多次化疗及化疗前白细胞低于正常;骨髓抑制临床症状多样性，无特异性;在骨髓抑制好发期监测血象及伴随症状，可以预防性治疗，减少骨髓抑制及伴随症的发生。结论： 妇科肿瘤化疗患者的骨髓抑制是多种复杂因素共同作用的结果，重视患者化疗前KPS评分、监测骨髓抑制好发期的血象及伴发症状，有助于预防化疗后的骨髓抑制。
【关键词】 卵巢肿瘤; 子宫肿瘤; 药物疗法，联合; 骨髓
[Abstract] Objective:To study the method of protecting gynecologic tumor patients against myelosuppression after chemotherapy. Methods: Clinical data including risk factors of myelosuppressio and clinical manifestations of 272 patients with gynecological tumor received chemotherapy were analyzed retrospectively. Results: Risk factors of myelosuppression were KPS scores ≤ 60, multiple chemotherapy, and leukopenia before chemotherapy. The clinical symptoms of myelosuppression were diversity, and nonspecific. In the period when myelosuppression was easy to occur, strengthening monitoring on blood and complications, and early detection and treatment, can reduce myelosuppression and incidence of complications, and improve curative results. Conclusions: There are differences among people in terms of risk factors to myelosuppression occurrence. Independent factor can forecast myelosuppression occurrence more accurately, but we can not identify individual factor at present.
[Key words]ovarian neoplasms; uterine neoplasms; drug therapy, combination; bone marrow
骨髓抑制是肿瘤患者化疗常见、严重的毒性反应，严重的骨髓抑制不仅妨碍化疗计划及剂量强度的实施，而且可危及患者的生命。为能更好的预防肿瘤患者化疗后骨髓抑制的发生，现将272例妇科肿瘤化疗患者的临床资料进行分析。
1资料和方法
1.1临床资料2006-2008年收治272例妇科肿瘤实施化疗的患者，按骨髓抑制的WHO诊断分级标准，未发生骨髓抑制的有111例(40.8%)，发生骨髓抑制的161例(59.2%);骨髓抑制Ⅰ度75例(27.6%)，Ⅱ度55例(20.2%)，Ⅲ度25例(77%)，Ⅳ度10例(3.7%)。年龄15~77岁，平均39.9岁;肿瘤类型包括卵巢恶性肿瘤(168例)，滋养细胞肿瘤(57例)、子宫内膜癌(17例)、宫颈癌(30例);化疗疗程包括首次化疗(105例)及多次化疗(167例);所采用的化疗方案及化疗药物因肿瘤类型不同而多样，常用方案(超过10例)有5种：PC方案(顺铂+环磷酰胺)12例、TP方案(紫杉醇+顺铂)72例、PAC方案(顺铂+阿霉素/吡柔比星+环磷酰胺)65例、PEB(顺铂+依托泊苷+平阳霉素/博来霉素)29例、EF(依托泊苷+氟尿嘧啶)35例。
1.2方法对骨髓抑制的相关危险因素、骨髓抑制的临床表现(外周血象及临床症状、伴随症状)、预后等资料进行回顾性分析。
1.3统计学
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