左旋门冬酰胺酶治疗儿童恶性肿瘤副作用的预防

PREVENTION OF ADVERSE REACTIONS CAUSED BY L-ASPARAGINASE IN CHILDREN WITH MALIGNANT TUMORS

目的探讨左旋门冬酰胺酶治疗儿童恶性肿瘤副作用的预防。方法对55例病儿于左旋门冬酰胺酶治疗前检查血常规、血凝常规、血淀粉酶、尿淀粉酶、血糖、尿糖、心电图及肝肾功能,均正常后给予生理盐水100 mL加左旋门冬酰胺酶6000-10000 U/（m^2.d）静脉滴注,隔日1次,共6-10次,密切观察及预防副作用。结果128例次治疗中出现过敏反应4例次,胃肠道反应11例次,低蛋白血症20例次,血凝异常37例次,无1例急性胰腺炎和糖尿病发生。由于及时观察及正确处理,无1例死亡。结论积极早期采取干预措施,预防肿瘤化疗副作用,才能保证化疗顺利进行。

Objective To study the prevention of adverse reactions caused by L-asparaginase in children with malignant tumors. Methods Fifty-five children with malignant tumors were involved in this study. Blood routine, clotting time, blood and urine glucose and amylase, ECG, renal and liver functions were detected with normal results before treatment. L-asparaginase of 6 000-10 000 U/（m^2 · day） in 100 mL NS, intravenous drip, every other day, for 6-10 doses. The side effects were closely observed. Results In 128 case/times treatments, the side effects showed as follows： allergic response （four patients）, gastrointestinal reaction （11）, hypoproteinemia （20） and abnormal hemagglutinin （37）. No acute pancreatitis or diabetes was noted. No pa tients died of side effects because of effective nursing and in-time management. Conclusion To ensure smooth chemotherapy, an early and active intervention should be taken to avoid any adverse reactions caused by Izasparaginase.