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目的探讨甲钴胺在乳腺癌多西紫杉醇化疗所致外周神经毒性中的防治效果。方法 60例采用多西紫杉醇化疗的乳腺癌患者,随机分为观察组和对照组,各30例。两组患者均选择含有多西紫杉醇的化疗方案实施化疗,观察组在化疗过程中应用甲钴胺治疗,对照组未应用甲钴胺治疗。观察两组患者化疗过程中外周神经毒性症状,记录两组患者出现外周神经毒性症状的时间以及发生外周神经毒性症状时多西紫杉醇的用药量。记录两组患者发生外周神经毒性症状的患者例数,计算发生率,并根据外周神经毒性症状程度进行分级。结果观察组中7例患者出现外周神经毒性症状,发生率为23.3%;对照组中16例患者出现外周神经毒性症状,发生率为53.3%;比较差异有统计学意义(P<0.05)。观察组中外周神经毒性症状分级:0级23例、1级5例、2级2例;对照组分别为0级14例、1级9例、2级5例、3级2例;比较差异具有统计学意义(P<0.05)。对照组发生外周神经毒性症状时间为(9.3±1.9)周,发生外周神经毒性症状时多西紫杉醇的量为(215±26)mg;观察组分别为(16.2±2.3)周、(320±33)mg;比较差异有统计学意义(P<0.05)。结论甲钴胺能够对乳腺癌多西紫杉醇化疗所致外周神经毒性产生较高防治效果,效果显著,值得借鉴。
Objective To investigate the prevention and treatment of mecobalamin in peripheral neurotoxicity caused by chemotherapy of docetaxel in breast cancer. Methods Sixty patients with breast cancer treated with docetaxel were randomly divided into observation group and control group, with 30 cases in each group. Chemotherapy was performed in both groups of patients receiving docetaxel-containing chemotherapy, while mecobalamin was used in the observation group and mecobalamin was not used in the control group. The symptoms of peripheral neurotoxicity in the two groups of patients during chemotherapy were observed. The time of appearance of peripheral neurotoxicity and the dose of docetaxel in the peripheral neurotoxicity were recorded. The number of patients with peripheral neurotoxic symptoms in both groups was recorded, the incidence was calculated, and the degree of peripheral neurotoxicity was graded. Results Peripheral neurotoxicity was observed in 7 patients (23.3%) in the observation group. Peripheral neurotoxicity was found in 16 patients (53.3%) in the control group. The difference was statistically significant (P <0.05). In the observation group, the symptoms of peripheral neurotoxicity were graded as follows: grade 0 in 23 cases, grade 1 in 5 and grade 2 in 2; control group were grade 0 in 14, grade 1 in 9, grade 2 in 5 and grade 3 in 2; Statistically significant (P <0.05). The duration of peripheral neurotoxicity in the control group was (9.3 ± 1.9) weeks and that of docetaxel in the peripheral neurotoxicity group was (215 ± 26) mg. The observation group was (16.2 ± 2.3) weeks, (320 ± 33) weeks ) mg; the difference was statistically significant (P <0.05). Conclusion Methylcobalamin is able to exert high preventive and therapeutic effects on peripheral neurotoxicity caused by chemotherapy of docetaxel in breast cancer, which has a remarkable effect and is worth learning from.