鞘内化疗相关的脊髓病1例并文献复习  

A case of myelopathy due to intrathecal chemotherapy and literature review

作　　者：冯娟[1] 董红娟[1] 段晓晖[1] 杨莉洁[1] 高广勋[1] 杨岚[1] 

机构地区：[1]第四军医大学西京医院血液内科,解放军血液病专病中心,陕西西安710032

出　　处：《现代肿瘤医学》2017年第20期3299-3301,共3页Journal of Modern Oncology

基　　金：陕西省科技攻关项目(编号:2010K01-163)

摘　　要：目的:探讨鞘内化疗相关脊髓病的临床表现、诊断与治疗,以提高临床医生对鞘内化疗相关脊髓病的认识。方法:总结1例男性急性髓系白血病患者,在多次鞘内化疗后继发脊髓病,表现为脊髓损害平面以下感觉异常、下肢无力及大小便困难等,给予抗神经毒治疗后,观察其病情演变及转归,并复习相关文献。结果:在营养神经、物理及针灸等治疗后患者脊髓病的相关症状逐渐减轻。结论:脊髓病是鞘内化疗的一种少见却严重的神经系统并发症,无特效治疗方案,预后不一,临床应加以重视。Objective：To discuss the clinical presentations,diagnosis and therapies of myelopathy due to intrathe- cal chemotherapy,and to improve the understanding of the disease for clinicians. Methods：The authors describe a male patient with acute myeloid leukemia, who developed myelopathy following intrathecal chemotherapy. Initial pres- entation was sensory disturbances below the level of spinal cord injury,lower limbs weakness and urine and fecal re- tention. We report the disease evolution and outcome after anti - neurotoxicity treatment, and review the related litera- ture. Results： The symptoms of myelopathy gradually were improved after neuro nutrition drugs, physical and acupunc- ture therapy. Conclusion： Myelopathy is a kind of rare but severe neurologic complication following intrathecal chemo- therapy ,without very effective treatment strategies. The clinical prognosis is variable. Physicians should be wary of this rare complication.

关 键 词：脊髓病 鞘内化疗 甲氨蝶呤 阿糖胞苷 

分 类 号：R733.3[医药卫生—肿瘤]