胶质瘤手术患者阿霉素局部化疗的并发症分析

Complications and their preventions of local chemotherapy with doxorubicin for cerebral glioma

目的观察局部应用阿霉素治疗胶质瘤患者的并发症及其预防措施。方法对手术治疗的32例胶质瘤患者手术灶处铺垫含有阿霉素2.5-10 mg的明胶海棉,并于瘤腔内留置ommaya化疗泵导管。术后经ommaya泵反复注入阿霉素2.5-5 mg/次,同时放疗者21例。结果 32例手术患者局部化疗2、3、4、5、6次者分别为9、9、7、2、3例,共122次。并发脑内出血5例次、癫痫3例次、颅内压增高并头痛3例7次。颅内出血者均同时合并放疗,颅内压增高并头痛者单次用阿霉素5 mg者5次、10 mg者2次。结论手术治疗胶质瘤患者行阿霉素局部化疗时可发生脑内出血、癫痫、头痛等并发症。调整单次阿霉素用量、避免同时放疗、减慢输注速度等可以避免这些并发症的发生。

Objective To analyze the complications and their prevention methods of topical adriamycin（ADM） treatment for cerebral glioma patients.Methods There were 32 cases of glioma patients in the study.2.5～10 mg ADM containing gelfoam was put in the tumor bed when the tumor removed by microsurgery,and then a ommaya pump was set in the tumor bed and under the head skin.After operation,2.5～5 mg ADM was injected via ommaya pump every 6～8 weeks,and the radiotherapy were treated in 21 cases at the same time.Results Thirty-two patients were selected for treatment by local chemotherapy 2,3,4,5,6 times in 9,9,7,2,3 cases respectively,total 122 times.There were some patients suffered complications with intracranial hemorrhage（5 cases）,epilepsy（3 cases） and headache（3 cases）.All cases of intracranial hemorrhage were concomitant radiotherapy,patients with increased intracranial pressure and headaches meet a single dose of ADM 5 mg in 5 times,10 mg in 2 times.Conclusions Surgical treatment of glioma patients with local chemotherapy with ADM maybe suffered with brain hemorrhage,epilepsy and headache.Adjustment of the dosage of ADM,to avoid radiation simultaneous and to slow down the speed of injection of ADM can avoid these complications.