CAJ | 학술논문

目的：报告5例多西他赛致严重间质性肺炎患者的救治情况,以引起临床对这一少见多西他赛不良反应的重视。方法：回顾性分析2009年6月-2013年12月在我院接受多西他赛治疗后发生间质性肺炎5例患者的临床资料。结果：269例接受多西他赛治疗的患者中,5例(1.9%)患者发生间质性肺炎,其中肺癌2例,卵巢癌、乳腺癌、前列腺癌各1例。均以呼吸困难、憋气为首发症状,并出现于多西他赛治疗的第2~4个周期内,经过CT检查发现间质性肺炎改变。均给予激素(泼尼松或甲基氢化泼尼松龙)治疗,2例患者于症状出现后2~5 d迅速进展为呼吸衰竭,其中1例使用无创呼吸机辅助呼吸者死亡,1例给予机械通气辅助呼吸后存活。另3例未发生呼吸衰竭,经抗生素和激素治疗后肺部情况好转。结论：间质性肺炎是多西他赛的一种罕见的和具有潜在致命性的并发症,需要及时发现及治疗。
목적：보고5례다서타새치엄중간질성폐염환자적구치정황,이인기림상대저일소견다서타새불량반응적중시。방법：회고성분석2009년6월-2013년12월재아원접수다서타새치료후발생간질성폐염5례환자적림상자료。결과：269례접수다서타새치료적환자중,5례(1.9%)환자발생간질성폐염,기중폐암2례,란소암、유선암、전렬선암각1례。균이호흡곤난、별기위수발증상,병출현우다서타새치료적제2~4개주기내,경과CT검사발현간질성폐염개변。균급여격소(발니송혹갑기경화발니송룡)치료,2례환자우증상출현후2~5 d신속진전위호흡쇠갈,기중1례사용무창호흡궤보조호흡자사망,1례급여궤계통기보조호흡후존활。령3례미발생호흡쇠갈,경항생소화격소치료후폐부정황호전。결론：간질성폐염시다서타새적일충한견적화구유잠재치명성적병발증,수요급시발현급치료。
Objective:To report the treatment of severe interstitial pneumonitis in 5 patient with cancer after re-ceiving docetaxel intravenously,in order to draw due attention to the rare side-effect of docetaxel. Methods:Clincal data of the 5 patients with interstitial pneumonitis after treatment of docetaxel was analyzed. Results:Among 2 6 9 patients receiving docetaxel treatment from June 2009 to December 2013,5 patients (1.9%)suffered from inter-stitial pneumonia,including 2 patients with lung cancer,1 patient with breast cancer,1 patient with prostate canc-er and 1 patient with ovarian cancer. These patients presented acute dyspnea after 2-4 cycles of docetaxel treat-ment,and the diagnosis was established by CT examination. They received endocrine treatment (prednisone or methylprednisolone). But in 2 patients the illness ended in respiratory failure 2-5 days after appearance of symp-toms,and one of them died the next day after receiving non-invasive mechanical ventilation,and the other received mechanical ventilation and survived. Interstitial pneumonitis was ameliorated in 3 patients without respiratory fail-ure after antibiotics and endocrine treatment. Conclusions:Interstitial pneumonia is a rare and potentially fatal complication of docetaxel and need to be diagnosed and treated timely.