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目的探讨消化道恶性肿瘤患者化疗后肝功能异常临床因素及干预对策。方法回顾性分析2008年1月至2013年1月500例消化道恶性肿瘤患者资料,分成两组,对照组239例,观察组261例。观察组在对照组基础上加用保肝药,比较两组肝功能异常发生率,并总结其临床表现以及危险因素。结果 500例恶性肿瘤患者中,化疗后肝功异常156例(31.2%),其中对照组109例(45.6%),观察组47例(18.0%)。临床表现以纳差、疲乏无力和恶心呕吐为主。肝功能异常以ALT,AST、ALP、γ-GT、TBL、ALB升高为主。年龄、化疗疗程、有无联合用药、有无肝转移、有无病毒性肝炎与恶性肿瘤患者化疗后肝功能异常有关(P<0.05)。结论消化道恶性肿瘤患者化疗后肝功能异常以转氨酶升高为主,未使用护肝药物患者的肝功能异常程度和发生率均高于使用护肝药物患者,临床化疗的同时需要应用护肝药物预防药物性肝损害。
Objective To investigate the clinical factors of liver dysfunction after chemotherapy in patients with gastrointestinal cancer and intervention measures. Methods The data of 500 patients with gastrointestinal malignancies from January 2008 to January 2013 were retrospectively analyzed. The data were divided into two groups: control group (239 cases) and observation group (261 cases). The observation group was given hepatoprotective drugs on the basis of the control group, and the incidence of liver dysfunction was compared between the two groups. The clinical manifestations and risk factors were also summarized. Results Among the 500 patients with malignant tumor, 156 cases (31.2%) had abnormal liver function after chemotherapy, including 109 cases (45.6%) in the control group and 47 cases (18.0%) in the observation group. Clinical manifestations of anorexia, fatigue and nausea and vomiting. Abnormal liver function to ALT, AST, ALP, γ-GT, TBL, ALB increased mainly. Age, chemotherapy, with or without combination, with or without liver metastases, with or without viral hepatitis and malignant tumor patients with liver dysfunction after chemotherapy (P <0.05). Conclusions The liver function abnormalities in patients with gastrointestinal cancer are mainly elevated with aminotransferase. The degree and incidence of liver dysfunction in patients without hepatoprotective drugs are higher than those in patients with hepatoprotective drugs. Chemotherapy with hepatoprotective drugs Prevention of drug-induced liver damage.