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使用长春新碱后发生的肠道假性梗阻。

Intestinal Pseudo-Obstruction After Vincristine Use.

作者信息

Monteiro Miguel, Castanheira Beatriz, Meireles Elsa, Príncipe Nuno, Paiva José-Artur

机构信息

Department of Intensive Care Medicine, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, PRT.

Department of Oncology, Unidade Local de Saúde de Almada/Seixal, Almada, PRT.

出版信息

Cureus. 2024 Nov 22;16(11):e74213. doi: 10.7759/cureus.74213. eCollection 2024 Nov.

DOI:10.7759/cureus.74213
PMID:39712677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11663289/
Abstract

A 73-year-old man presented with nausea, abdominal discomfort, and distention persisting for the past five days. He had previously been diagnosed with stage III peripheral CD4+ T cell lymphoma and had initiated chemotherapy comprising vincristine two weeks prior to presentation. An evaluation revealed diffuse colon distention and pneumatosis intestinalis without mechanical obstruction, consistent with acute colonic pseudo-obstruction. The patient underwent surgical intervention and was subsequently admitted to the Intensive Care Unit due to distributive shock. Vincristine-induced ileus followed by intestinal pseudo-obstruction was suspected to be the underlying cause after excluding alternative causative factors.

摘要

一名73岁男性，出现恶心、腹部不适及腹胀，持续5天。他之前被诊断为III期外周CD4 + T细胞淋巴瘤，在就诊前两周开始接受包含长春新碱的化疗。评估显示结肠弥漫性扩张及肠壁积气，无机械性梗阻，符合急性结肠假性梗阻。患者接受了手术干预，随后因分布性休克入住重症监护病房。在排除其他致病因素后，怀疑是长春新碱引起的肠梗阻继而导致肠假性梗阻为根本原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84f/11663289/b5d881387316/cureus-0016-00000074213-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84f/11663289/ea625e854f6a/cureus-0016-00000074213-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84f/11663289/b5d881387316/cureus-0016-00000074213-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84f/11663289/ea625e854f6a/cureus-0016-00000074213-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84f/11663289/b5d881387316/cureus-0016-00000074213-i02.jpg

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本文引用的文献

1
Vincristine in Cancer Therapy: Mechanisms, Efficacy, and Future Perspectives.长春新碱在癌症治疗中的作用机制、疗效及未来展望
Curr Med Chem. 2024 Sep 23. doi: 10.2174/0109298673319496240911060138.
2
Characterising vincristine-induced peripheral neuropathy in adults: symptom development and long-term persistent outcomes.描述长春新碱诱导的成人周围神经病变：症状发展和长期持续的结局。
Support Care Cancer. 2024 Apr 9;32(5):278. doi: 10.1007/s00520-024-08484-5.
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Preoperative Hyponatremia Indicates Complicated Acute Appendicitis.术前低钠血症提示复杂性急性阑尾炎。
Surg Res Pract. 2022 Mar 31;2022:1836754. doi: 10.1155/2022/1836754. eCollection 2022.
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Vincristine in Combination Therapy of Cancer: Emerging Trends in Clinics.长春新碱在癌症联合治疗中的应用：临床新趋势
Biology (Basel). 2021 Aug 31;10(9):849. doi: 10.3390/biology10090849.
5
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colonic Volvulus and Acute Colonic Pseudo-Obstruction.美国结肠和直肠外科医师协会关于结肠扭转和急性结肠假性梗阻管理的临床实践指南。
Dis Colon Rectum. 2021 Sep 1;64(9):1046-1057. doi: 10.1097/DCR.0000000000002159.
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Vincristine-Induced Peripheral Neuropathy (VIPN) in Pediatric Tumors: Mechanisms, Risk Factors, Strategies of Prevention and Treatment.长春新碱诱导的周围神经病（VIPN）在儿科肿瘤中的机制、危险因素、预防和治疗策略。
Int J Mol Sci. 2021 Apr 16;22(8):4112. doi: 10.3390/ijms22084112.
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Relationships between serum electrolyte concentrations and ileus: A joint clinical and mathematical modeling study.血清电解质浓度与肠梗阻的关系：一项联合临床与数学建模研究。
Physiol Rep. 2021 Feb;9(3):e14735. doi: 10.14814/phy2.14735.
8
A case series of 3 patients with acute colonic pseudo-obstruction after vincristine administration.一组3例使用长春新碱后发生急性结肠假性梗阻的病例系列。
Acta Gastroenterol Belg. 2020 Oct-Dec;83(4):660-662.
9
Endoscopic management of gastrointestinal motility disorders - part 2: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.胃肠动力障碍的内镜处理 - 第 2 部分：欧洲胃肠道内镜学会（ESGE）指南。
Endoscopy. 2020 Jul;52(7):600-614. doi: 10.1055/a-1171-3174. Epub 2020 May 27.
10
Endoscopic management of gastrointestinal motility disorders - part 1: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.胃肠动力障碍的内镜处理 - 第 1 部分：欧洲胃肠道内镜学会 (ESGE) 指南。
Endoscopy. 2020 Jun;52(6):498-515. doi: 10.1055/a-1160-5549. Epub 2020 May 6.