摘要
1例50岁女性患者,于2年前因卵巢中-低分化浆液性乳头状腺癌行全子宫、附件等切除术,术后行8个疗程化疗。此次因卵巢癌术后复发再次入院,给予卡铂注射液300 mg,qd,ivgtt。输注至约10 min时患者突然出现头晕、站立后跌倒,有短暂意识丧失、伴有心悸,恶心呕吐,神志清、精神不振、四肢厥冷,立即停用卡铂注射液,给予吸氧、心电、血氧监护。测T 35.5℃,HR 90~130次·min^(-1),R 25~30次·min^(-1),BP 60/35 mm Hg,SaO_2 60%~70%。急检心电图结果回报:窦性心律不齐,下壁心肌损伤。给予0.9%氯化钠注射液(500 m L,ivgtt)、地塞米松磷酸钠注射液(10 mg,iv)、异丙嗪注射液(25 mg,im)、多巴胺注射液(100 mg,ivgtt);同时急检脑钠肽(NT-pro BNP)1330 pg·m L^(-1),肌酸激酶同工酶(CK-MB)43.9 U·L^(-1)。经对症治疗2 h后,恶心、呕吐症状逐渐缓解,但仍有头晕、心悸症状,BP 98/54 mm Hg,持续多巴胺注射液升压治疗,50 h后BP100/70 mm Hg,T 36.8℃,HR 74次·min^(-1),R 18次·min^(-1),患者病情好转。
One 50-year-old female patient was admitted mainly because of postoperative recurrence of ovarian cancer. The patient underwent total resection of the uterus, accessories etc for poorly differentiated serous papillary adenocarcinoma of the ovary two years ago and recevied 8 courses of chemotherapy after that. After admission, carboplatin injection (300 mg, qd, ivgtt) was given to the patient. Ten minutes later, the patient developed dizziness, falling down, transient unconsciousness, palpitations, nausea,vomiting, cold limbs. Carboplatin injection was stopped immediately. And the patient was given oxygen, ECG and blood oxygenmonitoring. Vital signs were T 35.5 ℃, HR 90 – 130 times·min-1, R 25 – 30 times·min-1, BP 60/35 mm Hg, SaO2 60% – 70%. ECG test showed that sinus arrhythmia and inferior wall myocardial injury. Then, the patient was given 0.9% sodium chloride injection (500 mL, ivgtt), dexamethasone sodium phosphate injection (10 mg, iv), promethazine injection (25 mg, im), dopamine injection(100 mg, ivgtt). Blood test showed NT-proBNP was 1330 pg·mL-1, CK-MB was 43.9 U·L-1. After 2 hours, the phenomena of nauseaand vomiting gradually eased while dizziness and palpitation still existed. BP was 98/54 mm Hg. Dopamine injection was given tothe patient continuously. 50 h later, vital signs were BP 100/70 mm Hg, T 36.8 ℃, HR 74 times·min-1, R 18 times·min-1, the patient's condition improved.
作者
邵丹
于倩
王华
SHAO Dan;YU Qian;WANG Hua(Department of Pharmacy, China-Japan Union Hospital of Jilin University, Changchun 130031, China)
出处
《中国药物应用与监测》
CAS
2016年第6期389-391,共3页
Chinese Journal of Drug Application and Monitoring
基金
吉林省食品药品安全监测中心项目[(2015)科技字(474)号]
关键词
卡铂注射液
药品不良反应
过敏性休克
急性心肌损伤
Carboplatin injection
Adverse drug reaction
Allergic shock
Acute myocardial injury
