盐酸多柔比星脂质体所致间擦疹型Ⅳ级手足综合征合并感染1例病例报道并文献复习  

Grade Ⅳ intertrigo⁃like hand⁃foot syndrome caused by doxorubicin hydrochloride liposome complicated with infection:a case report and worldwide literature review

作　　者：石坚 谢钟芸 杨海峰 SHI Jian;XIE Zhongyun;YANG Haifeng(Department of Breast Surgery,Huaihua Tumor Hospital,Huaihua,418000,Hunan,China;Business School of Huaihua University,Huaihua,418000,Hunan,China)

机构地区：[1]怀化市肿瘤医院乳腺科,湖南怀化418000 [2]怀化学院商学院,湖南怀化418000

出　　处：《肿瘤药学》2024年第6期774-780,共7页Anti-Tumor Pharmacy

摘　　要：目的 通过病例分析多柔比星脂质体所致间擦疹型手足综合征的临床特点、危险因素及诊治方案,提醒临床医师在使用多柔比星脂质体时应密切关注用药安全。方法 对1例36岁女性乳腺癌患者使用多柔比星脂质体后出现间擦疹型Ⅳ级手足综合征合并感染的病例进行分析,并归纳和总结相关文献。结果 本例间擦疹型手足综合征可能由使用大剂量多柔比星脂质体(约每周18 mg·m-2)而引起,经对症支持、抗感染、延迟化疗等处理,患者全身多处皮肤损伤愈合。结论 在使用多柔比星脂质体治疗过程中,应重视患者宣教、积极预防和早期识别,尤其需要关注患者的临床表现,鉴别可能导致的间擦疹型手足综合征,避免影响患者的生活质量和治疗效果。Objective To analyze the clinical characteristics,risk factors,diagnosis and treatment of pegylated liposo-mal doxorubicin(PLD)-associated intertrigo-like hand-foot syndrome on a case-by-case basis,in order to remind clinicians to pay close attention to drug safety when using PLD.Methods The clinical case of a 36-year-old female breast cancer pa-tient with gradeⅣintertrigo-like hand-foot syndrome caused by doxorubicin hydrochloride liposome and complicated with infection was analyzed,and the relevant literature was summarized.Results In this case,the intertrigo-like hand-foot syn-drome was probably caused by high-dose(approximately 18 mg·m-2 per week)administration of doxorubicin hydrochloride liposome.After symptomatic support,anti-infection,delayed chemotherapy and other treatments,the patient's multiple skin lesions healed.Conclusion In the process of treatment with doxorubicin hydrochloride liposome,we should pay atten-tion to patient education,active prevention and early identification of the disease,especially pay attention to the clinical manifestations of patients,identify the possible of PLD-associated intertrigo-like hand-foot syndrome,so as to avoid affect-ing the quality of life and treatment effect of patients.

关 键 词：手足综合征 乳腺癌 间擦疹型 盐酸多柔比星脂质体 药物不良反应 汗腺 

分 类 号：R730.6[医药卫生—肿瘤] R737.9[医药卫生—临床医学]