Klein D S, Wilds P R
Can Anaesth Soc J. 1983 Jul;30(4):399-405. doi: 10.1007/BF03007863.
Agents commonly used in the treatment of neoplastic diseases may impair pulmonary function, and a wide spectrum of agents are currently implicated as toxic to the pulmonary system. Agents most commonly implicated are bleomycin, carmustine, busulfan, methotrexate, and thoracic radiotherapy. Less commonly implicated agents include mitomycin, procarbazine, melphalan, chlorambucil, and cyclophosphamide. Therapeutic interactions at time of operation and postoperatively may exacerbate existing pulmonary damage. It is imperative for the physicians treating patients receiving antineoplastic therapy to recognize potentially dangerous therapeutic interactions, and adjust the therapeutic regimen accordingly. Concentrations of inspired oxygen must be maintained as low as is safely possible. Intraoperative monitoring of arterial and mixed venous oxygen tensions will enable the clinician to adjust inspired oxygen concentrations to the lowest possible level while maintaining adequate oxygen tensions to the tissues. A systematic review of antineoplastic agents currently implicated, drug-oxygen interactions, and a review of the pathophysiology are presented.
常用于治疗肿瘤疾病的药物可能会损害肺功能，目前有多种药物被认为对肺系统有毒性。最常涉及的药物是博来霉素、卡莫司汀、白消安、甲氨蝶呤和胸部放疗。较少涉及的药物包括丝裂霉素、丙卡巴肼、美法仑、苯丁酸氮芥和环磷酰胺。手术时及术后的治疗相互作用可能会加重现有的肺损伤。对于治疗接受抗肿瘤治疗患者的医生来说，认识到潜在危险的治疗相互作用并相应调整治疗方案至关重要。吸入氧气的浓度必须尽可能安全地保持在低水平。术中监测动脉血氧分压和混合静脉血氧分压将使临床医生能够将吸入氧气浓度调整到尽可能低的水平，同时维持组织足够的氧分压。本文对目前涉及的抗肿瘤药物、药物与氧气的相互作用以及病理生理学进行了系统综述。
