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shun bo zhi guo min xing xiu ke ban fang pu 1 li
Author(s): 
Pages: 89-89
Year: Issue:  1
Journal: Pharmaceutical and Clinical Research

Keyword:  顺铂过敏性休克房扑严重不良反应;
Abstract: 1病例简况患者,女,36岁。因“肺癌术后2年,胸闷气短半月”入院。术后1月余予“多西他赛+卡铂”化疗,静滴多西他赛时患者出现心悸、胸闷、面红、全身肌肉酸痛等过敏反应,并伴有心率加快,血压、血氧饱和度(SpO2)降低,给予停药、吸氧等处理后症状消失。入院查体:体温(T)36.8℃,脉搏(P)80次/分,呼吸(R)18次/分,血压(BP)120/70 mmHg,左颈部可及数个肿大淋巴结,右下肺呼吸音减低,两肺无干湿啰音,心率(HR)80次/分,心律齐。胸部CT 提示左肺多发结节,转移可能;骨扫描提示全身多发性骨代谢活跃,考虑骨转移。入院第5天起给予培美曲塞0.8 g d1+顺铂30 mg d2~3化疗,次日患者首次静脉滴注顺铂约1/3时突发胸闷、心悸、恶心、剧烈呕吐、面色苍白、大汗淋漓。心电监护提示HR 153次/分(房扑)、BP 90/60 mmHg、SpO285%,急查心电图提示房扑(房室传导2∶1)、ST段压低。立即停用顺铂、吸氧(3 L·min-1)、地塞米松10 mg静推、西地兰0.4 mg静推。15 min后患者症状缓解,查各项生理指标正常,心电图未见异常。
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