CAJ | 학술논문

目的：分析贝伐珠单抗联合化疗后昏迷患者的临床特征、危险因素、治疗转归，提高对贝伐珠单抗联合化疗治疗转移性结直肠癌毒性的认知和预防水平。方法：报道2例贝伐珠单抗联合化疗后昏迷患者的临床特征及诊治过程，结合国内外文献进行分析。结果：血压控制不佳是贝伐珠单抗联合化疗后昏迷的危险因素，临床表现为可逆的后部脑白质病变综合症，患者可以无典型的影像学表现，加强血压控制等支持治疗，患者预后良好。结论：贝伐珠单抗联合化疗导致患者昏迷并不少见，因此需慎用于有高血压病史的患者，治疗期间密切监测血压变化，经过提高警惕和及时处理，预防昏迷出现。同时在出现以后，通过积极治疗，昏迷也是可逆的并发症。
목적：분석패벌주단항연합화료후혼미환자적림상특정、위험인소、치료전귀，제고대패벌주단항연합화료치료전이성결직장암독성적인지화예방수평。방법：보도2례패벌주단항연합화료후혼미환자적림상특정급진치과정，결합국내외문헌진행분석。결과：혈압공제불가시패벌주단항연합화료후혼미적위험인소，림상표현위가역적후부뇌백질병변종합증，환자가이무전형적영상학표현，가강혈압공제등지지치료，환자예후량호。결론：패벌주단항연합화료도치환자혼미병불소견，인차수신용우유고혈압병사적환자，치료기간밀절감측혈압변화，경과제고경척화급시처리，예방혼미출현。동시재출현이후，통과적겁치료，혼미야시가역적병발증。
Objective:The clinical features, risk factors, and outcomes of coma were analyzed in patients treated with bevacizum-ab combined with chemotherapy This study also aims to increase the awareness on the toxicity of this regimen. Methods:Two cases of coma induced by bevacizumab combined with chemotherapy were reported. Diagnosis, treatment, and relevant literature were reviewed and discussed. Results:Inadequate blood pressure (BP) control was one of the risk factors leading to coma in patients treated with this therapy. The clinical feature of these patients was reversible posterior leukoencephalopathy syndrome (RLPS). Imaging results showed no typical finding. Reinforced supportive treatment including intensive BP control showed satisfactory outcomes. Conclusion:Coma is common in patients treated with bevacizumab combined with chemotherapy. This regimen should be used cautiously in patients with a history of hypertension. BP should be monitored closely and managed promptly during the combination therapy to prevent coma. RLPS-related coma is reversible after appropriate treatment.