昂丹司琼和高乌甲素联用致唾液腺肿大2例

Salivary glands swelling induced by ondansetron combined with lappaconitine in two patients

2例患者在手术后使用昂丹司琼和高乌甲素静脉镇痛泵治疗时出现双侧下颌下腺、腮腺肿大。例1为30岁女性卵巢肿瘤、宫颈炎患者,接受卵巢肿瘤剥除术后分别给予头孢地嗪、奥硝唑静脉滴注,并给予昂丹司琼16 mg+高乌甲素64 mg加入0.9%氯化钠注射液80 ml经静脉镇痛泵镇痛、止吐。9 h后出现双侧下颌下腺、腮腺肿大,立即关闭镇痛泵,给予地塞米松10 mg静脉注射,5 d后唾液腺肿大消失。例2为42岁女性子宫肌瘤、早孕患者,接受次全子宫切除术后,给予头孢呋辛、左氧氟沙星分别静脉滴注,并使用昂丹司琼8 mg+高乌甲素40 mg加入0.9%氯化钠注射液95 ml静脉泵入用于镇痛、止吐。8 h后出现双侧下颌下腺、腮腺肿大并伴有心悸、胸闷和呼吸困难,立即关闭镇痛泵,给予地塞米松10 mg静脉注射,异丙嗪25 mg肌内注射。次日唾液腺肿大明显缩小,呼吸困难缓解,7 d出院。

Two patients developed swelling of submandibular glands and parotid glands due to combined use of ondansetron and lappaconite via an intravenous analgesia pump after surgery. Patient 1, a 30-year-old woman with ovarian tumor and cervicitics, received Ⅳ cefodizine and Ⅳ ornidazole respectively, and ondansetron 16 mg and lappaconitine 64 mg in 100 ml of sodium chloride injection 0. 9% were administered via an intravenous analgesia pump for control of vomiting and relief of pain after undergoing ovarian tumor resection. Nine hours later, swelling of bilateral submandibular glands and parotid glands occurred. The analgesia pump was removed immediately and Ⅳ dexamethasone 10 mg was given. After 5 days, her salivary glands swelling subsided. Patient 2, a 42-year-old woman with hysteromyoma and early pregnancy, received an infusion of eefuroxime and an infusion of levofloxacin, respectively, and ondansetron 8 mg plus lappaconitine 40 mg in 95 ml of sodium chloride injection 0. 9% were administered via an intravenous analgesia pump for control of vomiting and relief of pain after undergoing subtotal hysterectomy. Eight hours later, the patient developed swelling of bilateral submandibular glands and parotid glands accompanied with palpitation, chest distress and dyspnea. The analgesia pump was removed immediately and Ⅳ dexamethasone 10 mg and IM promethazine 25 mg were given. The next day, her salivary glands swelling was markedly subsided and her dyspnea relieved.