多柔比星脂质体致急性喉头水肿  

Acute laryngeal edema induced by doxorubicin liposome

作　　者：支勇金 周芬芬 闻梦静 吴正东[1] 朱剑锋[1] Zhi Yongjin;Zhou Fenfen;Wen mengjing;Wu Zhengdong;Zhu Jianfeng(Department of Hematology,Taizhou People′s Hospital Affiliated to Nantong University,Jiangsu Province,Taizhou 225300,China)

机构地区：[1]南通大学附属泰州市人民医院血液科,225300

出　　处：《药物不良反应杂志》2020年第5期315-316,共2页Adverse Drug Reactions Journal

摘　　要：1例69岁男性患者因外周T细胞淋巴瘤接受含多柔比星脂质体方案化疗。化疗第1周期患者无特殊不适。第2周期静脉滴注多柔比星脂质体过程中患者出现短暂肌肉酸痛。第3周期化疗在应用多柔比星脂质体前给予地塞米松和氯苯那敏预防过敏反应,并严格限制滴注速度,但在滴注约20 min时患者出现恶心、呕吐,立即暂停滴注,改为0.9%氯化钠注射液250 ml静脉滴注。随后患者出现面部麻木、喉痛、颈部不适及多部位皮疹伴瘙痒,心电监护示心率130次/min,血压80/50 mmHg(1 mmHg=0.133 kPa),血氧饱和度0.98。立即给予吸氧并使患者处于半卧位,约20 min后患者出现呼吸困难、声音嘶哑、口齿不清等症状,检查见舌体肥大、颈部肿胀,考虑多柔比星脂质体致急性喉头水肿,立即给予地塞米松10 mg静脉注射、10%葡萄糖酸钙10 ml静脉滴注及布地奈德吸入气雾剂雾化吸入。约3 h后患者症状逐渐好转;2 d后过敏症状消失。A 69-year-old male patient with peripheral T-cell lymphoma received chemotherapy with intravenous doxorubicin liposome.In the first chemotherapy cycle,no obvious adverse reactions appeared.In the second chemotherapy cycle,the patient developed transient muscle soreness during the IV infusion of doxorubicin liposome.In the third chemotherapy cycle,dexamethasone and chlorphenamine were given to prevent anaphylaxis before doxorubicin liposome treatment and the infusion rate was controlled in a standardized way.However,at about 20 minutes of infusion,the patient developed nausea and vomiting.The infusion of doxorubicin was stopped immediately and replaced by IV infusion of 0.9%sodium chloride injection 250 ml.Then the patient developed facial numbness,laryngeal pain,neck discomfort,and multiple parts of skin rash with pruritus.The electrocardiogram monitoring showed heart rate 130 times/min,blood pressure 80/50 mmHg,and oxygen saturation 0.98.The patient was given oxygen inhalation and in half-lying position following the doctor′s advice,but the patient developed dyspnea,hoarseness,and slurred speech 20 minutes later.Physical examination showed the patient′s tongue was hypertrophic,his neck was swollen and thickened.Acute laryngeal edema induced by doxorubicin liposome was considered.Intravenous injection of dexamethasone 10 mg,IV infusion of 10%calcium gluconate,and aerosol inhalation of budesonide inhalation aerosol were given immediately and about 3 hours later,the symptoms gradually improved.Two days later,the allergic symptoms disappeared.

关 键 词：多柔比星 脂质体 过敏反应 喉水肿 

分 类 号：R730[医药卫生—肿瘤]