Investigation And Analysis Of The Route Of Chemotherapy Drug Administration In Lung Cancer

Objective:(1)To retrospectively analyze the chemotherapy of lung malignant tumor in a hospital,and to discuss the differences and advantages and disadvantages of the routes of chemotherapy drugs in drug regimen,chemotherapy dose,adverse reactions of chemotherapy drugs,and adverse reactions related to the routes of chemotherapy drugs in lung cancer.In order to solve the individual treatment,in the face of evidence-based medicine shows that there are multiple ways of drug delivery can effectively control the patient's tumor,how to choose the best way of drug delivery,clinical reference to provide each lung cancer chemotherapy mode.(2)Summarize the unreasonable drug use characteristics of various chemotherapy drug delivery routes,so as to provide clinical reference for clinical pharmacists when facing specific chemotherapy drug delivery routes.Methods:According to the inclusion and exclusion criteria,331 eligible patients who were diagnosed with primary lung cancer and hospitalized in a grade a hospital from January 2016 to January 2018 and received a total of 1307 times of chemical treatment were selected as the study subjects by retrospective investigation and analysis.Review electronic medical records,general inpatient information table,clinical medical records and doctor's orders,and record the patient's information in detail:Record the medical record number,gender,age,admission diagnosis time,tumor type,stage,metastasis,KPS score,chemotherapy program,medication route,chemotherapy dose,the irrational use of chemotherapy and the manifestations,degree,duration and treatment measures of adverse reactions.The characteristics of chemotherapy medication of lung cancer patients in this hospital were summarized,and the data were statistically analyzed using excel software and Graphpad Prism 5 software.To analyze and evaluate the types,dosages,drug pathway related adverse reactions,adverse drug reactions and unreasonable drug use of chemotherapy drugs in different drug routes of lung cancer.Results:(1)Among 1307 times of lung cancer chemotherapy,peripheral venous route accounted for 45.98%,central venous route for 38.48%,bronchial artery infusion route for 9.94%,intrapleural infusion for 4.36%,and oral chemotherapy for 1.22%.(2)Types and doses of chemotherapy drugs:the types and doses of chemotherapy drugs used by the central and peripheral venous routes are basically the same;The chemotherapy regimen of pleural perfusion was cisplatin injection alone.Bronchial artery perfusion chemotherapy was combined with chemotherapy.Oral chemotherapy with gonoderm capsule was more common;Among the multiple routes of cisplatin injection chemotherapy,except the oral route,the dose of cisplatin was the highest in central vein chemotherapy and peripheral vein chemotherapy,followed by bronchial artery infusion,and the lowest in thoracic cavity.(3)Adverse reactions to chemotherapy in lung cancer:Peripheral venous route adverse reactions were mainly manifested as phlebitis and drug extravasation.Among the 32 cases of drug extravasation,5 cases resulted in severe tissue necrosis,and among the 32 cases,24 cases were over 70 years old,accounting for 75%;The incidence of phlebitis was 1.59%lower than that of peripheral veins.Adverse reactions in the central venous route were mainly manifested as deep venous thrombosis;Adverse reactions in the thoracic perfusion route showed pleural reaction,in which 1 case was complicated with cerebral infarction,and the incidence of infection in the thoracic perfusion puncture site was 8.77%higher than that in other routes;The route of bronchial artery infusion was femoral artery hematoma.Drug-related adverse reactions:in terms of the common adverse reactions of chemotherapy drugs such as digestive tract and bone marrow suppression,the incidence rate of intravenous administration route is higher than that of oral administration and thoracic perfusion route.(4)Of the 2863 medical advices for chemotherapy,2682 were qualified,with a qualified rate of 93.68%.The unreasonable use of chemotherapy for lung cancer is shown as follows:The route of oral administration is unreasonable.The routes of thoracic perfusion chemotherapy are unreasonable in operation,indications and drug regimen.The pretreatment of bronchial artery infusion chemotherapy is unreasonable,the dosage is unreasonable,and the indications of the patients with postoperative recurrence are unreasonable.The common medication plan,dosage and adjuvant medication are unreasonable.Conclusion:(1)By central venous or peripheral venous chemotherapy drug delivery way to treat lung cancer:they are used in chemotherapy and chemotherapy drug dose on basic consistent,relative to the dosage of peripheral vein,central vein to medicine has to avoid drug exosmosis,tissue necrosis,reduce the advantages of peripheral phlebitis for elderly patients with blood vessel brittleness is bigger,easy to cause other chemotherapy drug exosmosis of the population and repeated chemotherapy has benefit;However,the central venous administration is prone to the occurrence of deep vein thrombosis of the limbs on the side of drug injection,so the peripheral venous administration route is recommended for the patients with high blood coagulation,venous thrombosis disease and cerebral infarction.(2)For patients with lung cancer who have bleeding tendency,attention should be paid to femoral artery hematoma.The connection between the inpatient department and the interventional treatment department may lead to unreasonable pretreatment.For patients with postoperative recurrence of lung cancer,before selecting the route of administration,it is necessary to inquire whether the surgical record has cut off the supply side bronchial artery.(3)In the treatment of lung cancer by thoracic perfusion,chemotherapy drugs are selected in a single way.Compared with other drug delivery methods,the advantages are as follows:The dose of cisplatin was the lowest,and the patients had mild bone marrow suppression and gastrointestinal reaction.The disadvantages are:there are severe cases such as pleural reaction or even cerebral infarction,puncture point infection,repeated invasive operation of chest puncture and drainage,etc.Therefore,it is suggested to prevent in advance and make good communication when choosing this route.For ordinary patients,low dose of cisplatin does not emphasize hydration.In this paper,it was found that the use of cisplatin does not emphasize hydration for patients who eat less food accompanied by diabetes and other basic diseases that may lead to renal function damage,and acute renal failure may occur.Therefore,it is suggested that sufficient hydration in similar situations is beneficial to patients.(4)There are relatively few kinds of oral drug preparations for lung cancer,so it is necessary to avoid the use of drugs without indications for lung cancer treatment such as sergio capsules.There are some cases of peptic ulcer and bleeding in oral administration.Check for peptic ulcer before administration,and timely prevention is beneficial to patients.(5)Irrational drug use in different drug delivery routes presents different characteristics.According to these characteristics,it can provide reference for clinical pharmacists to guide clinicians in rational drug use and improve the safety of chemotherapy drug use.