Clinical Study Of Prevention Of Ⅲ/Ⅳ Degree Of Neutropenia After Chemotherapy With PEG-rhG-CSF Based On Risk Assessment Of FN

Objective:This study was to investigate the clinical significance of PEG-rhG-CSF in preventing III-IV neutropenia after chemotherapy,and to provide clinical basis for the standardized application of PEG-rhG-CSF after chemotherapy..Method:The FN risk assessment form and blood myelosuppression evaluation methods before and after chemotherapy were used to evaluate the risk of FN in patients undergoing chemotherapy in our hospital.Chi-square test and rank sum test were used to analyze the incidence of patients with III/IV neutropenia and the completion rate of full-dose chemotherapy,and to explore the influence of hospitalization time,incidence of infection,and antibiotic use.Results:1.The incidence of grade III neutrophilia in the primary prevention group was 4.76%(2/42),9.52%(4/42),5.56%(2/36),and 3.45%(1/29)in each chemotherapy cycle.The incidence of grade IV neutropenia was 30.95%(13/42),7.14%(3/42),19.44%(7/36),and 20.69%(6/29).The incidence of grade III neutropenia in each chemotherapy cycle in the secondary prevention group was 5.79%(11/190),5.26%(10/190),7.81%(10/128),and 1.15%(1/87)The incidence of grade IV neutropenia was 14.74%(28/190),7.37%(14/190),5.47%(7/128),and 5.75%(5/87).The 1st and 2nd cycles of chemotherapy in the primary prevention group significantly reduced the incidence of grade IV neutropenia after chemotherapy(P=0.005),with statistically significant differences.The screening period in the secondary prevention group and subsequent use of PEG-rhG-CSF in the 1,2 and 3 cycles of chemotherapy significantly reduced the incidence of grade IV neutropenia afterchemotherapy in patients(P=0.022;P=0.010;P=0.032),the results are statistically different.2.The patients in the primary prevention group received adequate doses of chemotherapy in all chemotherapy cycles;the complete doses of chemotherapy in the secondary prevention group were 92.63%(176/190),97.89%(186/190),and 98.44%(126/128).),100%(87/87).The use of PEG-rhG-CSF prophylactic whitening in the secondary prevention group was more effective than the screening period to ensure the completion rate of patients with full-dose chemotherapy(P=0.016;P=0.020;P= 0.000),with statistically significant differences.3.In the PEG-rhG-CSF treatment group,the incidence of I-IV neutropenia was 30%(6/20),35%(7/20),5%(1/20),and 30%(6/ 20).RhG-CSF combined with PEG-rhG-CSF treatment group,the incidence of I-IV neutropenia 5%(1/20),15%(3/20),5%(1/20),5%(1/20).RhG-CSF combined with PEG-rhG-CSF could significantly reduce the incidence of grade I and IV neutropenia compared with PEG-rhG-CSF alone(P= 0.037;P=0.037),with statistical differences.Conclusion:1.Primary prevention and secondary prevention using PEG-rhG-CSF can effectively reduce the incidence of III-IV neutropenia after chemotherapy,and the efficacy of multiple chemotherapy cycles is consistent.2.Prophylactic administration of PEG-rhG-CSF after chemotherapy can ensure completion of full-dose chemotherapy in patients.3.rh G-CSF continued PEG-rhG-CSF prevention of neutropenia after chemotherapy than PEG-rh G-CSF alone.