目的：Oxaliplatin 常與fluorouracil、calcium folinate 併用，為轉移性結腸直腸癌化學治療首選藥物。Oxaliplatin 過敏反應大多輕微但亦可能發生如支氣管痙攣、心跳加速、低血壓等危及生命之症狀。為探討如何避免此不良反應，某區域教學醫院針對曾發生oxaliplatin 過敏反應之病人，藉由延長輸注時間以降低同一病人再度發生

oxaliplatin 過敏之比率。

方法： 以回溯性世代研究， 蒐集2010 年1 月至2015 年12 月期間所有接受oxaliplatin 治療且發生過敏的病人，以oxaliplatin 輸注時間比較同一病人再度發生過敏之機率及評估其過敏嚴重度。

結果：研究期間曾施打oxaliplatin 共有349 位，發生過敏又再接受oxaliplatin治療之人數為34 人，過敏發生率為9.7%，最常出現在重複注射第十次後。於再度投藥時，將oxaliplatin 輸注時間分為4 小時以上與不足4 小時兩組相比，其降低過敏再發之成功率分別為91.7% 及33.3%，p = 0.001；再依過敏嚴重程度分析，輕度及重度過敏發生率，前者為0.0%及62.2%，p = 0.001，後者則為0.0%及80.0%，p = 0.14。藉由臨床藥師宣導及處方醫囑系統提示，使得同一病人過敏再發率由60.4% 降至0%(p = 0.007)。
結論：本研究結果顯示oxaliplatin 輸注時間延長至4 小時以上可顯著降低過敏反應再發生率。因此，除了藉由化療處方醫囑系統之提示管控並加強醫療照護人員對過敏反應防範及再發之處理對策宣導，以期降低oxaliplatin 過敏再發生率。

Objective: Oxaliplatin is typically administered with fluorouracil and calcium folinate as a combination treatment for metastatic colorectal cancer. Oxaliplatininduced hypersensitivity reactions (HSR) are mostly mild, but fatal adverse effects such as bronchospasm, tachycardia and hypotension may also occur. In order to prevent the adverse effect, we tried to reduce the incidence of recurrent oxaliplatin-induced HSR through prolonging the infusion time.
Methods: We performed a retrospective analysis of patients with allergic reactions to oxaliplatin treatments at a regional teaching hospital between January 2010 and December 2015. We compared the incidence and severity of oxaliplatin-related allergic reactions between different lengths of infusion time.
Results: A total of 349 patients received oxaliplatin, with 34 patients (9.7%) experiencing allergies. The symptoms most frequently occurred on the tenth exposure of the regimen. The success rate of relieving allergies was 91.7% in the group of infusion time more than 4 hours and 33.3% in the control group (p = 0.001). The incidence of mild allergy was 0.0% and 62.2% in the two group (p = 0.001), and
the incidence of severe allergy was 0.0% and 80.0% (p = 0.14). The recurrence risk of oxaliplatin-induced HSR decreased from 60.4% to 0% through promoting the prevention methods to clinicians and showing alert on the Hospital Information System (HIS) (p = 0.007).
Conclusions: The results shows that prolonging infusion time can significantly reduce the incidence allergic reactions. Also, by displaying alert message on the HIS and increasing clinicians and pharmacists’ awareness in the prevention methods, we believe that recurrence of oxaliplatin-induced HSR can be prevented.