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顺铂诱导的伴有血流动力学崩溃的心脏性猝死:一种严重的药物不良反应:病例报告

Cisplatin-induced sudden cardiac death with hemodynamic collapse: a severe adverse drug reaction: Case report.

作者信息

Abramavicius Silvijus, Zemaitis Marius, Pilvinis Vidas, Kadusevicius Edmundas

机构信息

Institute of Physiology and Pharmacology Department of Pulmonology Department of Intensive Care, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

Medicine (Baltimore). 2017 Dec;96(48):e8995. doi: 10.1097/MD.0000000000008995.

Abstract

RATIONALE

Cisplatin is responsible for a significant percentage of adverse drug reactions (ADRs) in oncology setting. A great proportion of cisplatin-induced severe adverse events are difficult to foresee, and giving premedication does not always prevent the occurrence of such events.

PATIENT CONCERNS

A 53-year-old woman with progressive T4 N0 M0 stage IV pleural mesothelioma experienced cardiac arrest with hemodynamic collapse after cisplatin and pemetrexed chemotherapy administration.

DIAGNOSES

Progressive pleural T4 N0 M0 stage IV mesothelioma of the right lung, primary arterial hypertension, and cardiac arrest with hemodynamic collapse.

INTERVENTIONS

The cisplatin and pemetrexed chemotherapy was administered intravenously for progressive pleural T4 N0 M0 stage IV mesothelioma of the right lung. During infusion of cisplatin the patient developed cardiac arrest, and cardiopulmonary resuscitation was initiated.

OUTCOMES

The patient was treated in intensive care unit and recovered successfully. Further chemotherapy with cisplatin and pemetrexed was withheld due to this severe adverse reaction to cisplatin.

LESSONS

Cisplatin therapy should be thoroughly monitored including electrolyte, especially magnesium levels. Absence of previous ADRs to cisplatin and premedication should not give false sense of security.

摘要

理论依据

顺铂在肿瘤治疗中导致了相当比例的药物不良反应(ADR)。很大一部分顺铂引起的严重不良事件难以预见,且给予预处理并不总能预防此类事件的发生。

患者情况

一名53岁女性,患有进展期T4 N0 M0 Ⅳ期胸膜间皮瘤,在接受顺铂和培美曲塞化疗后发生心脏骤停并伴有血流动力学崩溃。

诊断

右肺进展期胸膜T4 N0 M0 Ⅳ期间皮瘤、原发性动脉高血压、心脏骤停并伴有血流动力学崩溃。

干预措施

对右肺进展期胸膜T4 N0 M0 Ⅳ期间皮瘤静脉给予顺铂和培美曲塞化疗。在输注顺铂期间,患者发生心脏骤停,随即开始心肺复苏。

结果

患者在重症监护病房接受治疗并成功康复。由于对顺铂的这种严重不良反应,停止了进一步的顺铂和培美曲塞化疗。

经验教训

应全面监测顺铂治疗情况,包括电解质,尤其是镁离子水平。既往无顺铂药物不良反应及预处理不应让人产生错误的安全感。

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