EGFR-TKIs相关重度皮疹的治疗和护理
Treatment of severe skin rashes induced by epidermal growth factor receptor tyrosine kinase inhibitors
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摘要: 目的 探讨应用米诺环素、甘油止痒洗剂结合护理干预措施,对表皮受体酪氨酸激酶抑制剂(EGFR-TKIs)致晚期非小细胞肺癌(NSCLC)患者重度皮疹的疗效。方法 吉非替尼或厄洛替尼治疗相关重度皮疹的NSCLC患者28例,严重程度分级均为3级,给予米诺环素200mg口服2/d,甘油止痒洗剂适量抹患处3/d,结合护理干预措施。结果 10例患者皮疹完全消退,14例降为1级、3例降为2级,1例经处理无效且主观症状加重而终止EGFR-TKIs治疗,总体有效率96.4%。干预前后HAMA(P<0.001)和HAMD评分(P<0.001)改善有显著差异。结论 局部应用甘油止痒洗剂,口服米诺环素,结合护理干预措施,可作为一个较好的方案用于EGFR-TKIs致重度皮疹的处理。Abstract: Objective To study the therapeutic effect of glycerine anti-itching lotion,minocycline in combination with nursing intervention on severe skin rashes induced by epidermal growth factor receptor tyrosine kinase inhibitors（EGFR-TKIs） in patients with non-small cell lung cancer（NSCLC）.Methods Grade 3 skin rashes induced by erlotinib or gefitinib were treated with oral minocycline（200mg,twice a day） and local application of glycerine anti-itching lotion（3 times a day） in combination with nursing intervention in 28 NSCLC patients.Results Skin rashes were completely disappeared in 10 patients,decreased to grade 1 in 14 patients and to grade 2 in 3 patients,progressed in 1 patient who withdrew from EGFR-TKIs treatment due to exacerbated subjective symptoms.The total effective rate was 96.4%.The HAMA and HAMD scores were significantly higher after intervention than before intervention（P＜0.001）.Conclusion Local application of glycerine anti-itching lotion and oral minocycline in combination with nursing intervention are effective against severe skin rashes induced by EGFR-TKIs.
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