摘要
患儿男,10岁8个月,因非霍奇金淋巴瘤入院化疗。于化疗第8、15、22天静脉推注长春新碱2mg,1次/d,并同时静脉泵入柔红霉素50mg。第3次使用柔红霉素后42h,患儿突然神志不清,瞳孔散大,对光反射消失,呼吸停止,血压测不出,心室颤动。心电图示心脏停搏。急行抢救措施,2min后出现窦性心律,意识逐渐恢复。之后又出现2次类似发作,每次持续约10min。3d后24h心电图示单发房性早搏9次、室性早搏1次,全程ST段改变。随诊2年,患者未再用柔红霉素,长春新碱继续使用,未再出现类似发作。
A boy aged ten years and eight months with non-Hodgkin lymphoma was hospitalized for chemotherapy. On day 8,15, and 22 of chemotherapy,the patient received an IV push of vincristine 2 mg once daily and an IV infusion of daunorubicin 50 mg via pump. Forty-two hours after the third administration of daunorubicin,he suddenly developed confusion,mydriasis,disappeared light reflex,respiratory arrest, undetectable blood pressure, ventricular fibrillation. Electrocardiogram showed cardiac arrest. The resuscitations were given immediately and,two minutes later,he experienced sinus rhythm and his consciousness recovered gradually. Subsequently,he presented with another two similar episodes and each episode lasted for about 10 minutes. Three days later,a 24-hour ECG revealed 9 isolated atrial premature beats,1 ventricular premature beat,and widespread ST-segment changes. At 2-year follow up,daunorubicin was not given and vincristine was continued,and the patient had no recurrence of similar episode.
出处
《药物不良反应杂志》
2010年第3期204-206,共3页
Adverse Drug Reactions Journal
基金
北京市卫生局首都医学发展科研基金(2007-1030)
关键词
柔红霉素
不良反应
心脏毒性
心脏停搏
daunorubicin
adverse reactions
cardiotoxicity
cardiac arrest
