30例奥沙利铂致严重过敏反应的临床资料分析

Clinical Data Analysis of 30 Cases of Severe Oxaliplatin-Induced Allergic Reactions

探讨奥沙利铂过敏反应的临床特点及防治策略。方法:分析2010年1月至2017年12月北京市朝阳区三环肿瘤医院30例奥沙利铂致严重过敏患者的病例资料,归纳临床特征。结果:30例患者均在多周期使用奥沙利铂后发生过敏反应,给药后即刻或10 min内出现,临床表现主要包括:胸闷、呼吸困难、口唇紫绀、结膜充血水肿、荨麻疹、乏力、恶心、呕吐、腹痛、休克等。1例严重血小板下降、出血。抢救措施:首先停用奥沙利铂,同时给予抗组胺药物、糖皮质激素、肾上腺素等治疗,约15～30 min症状缓解。结论:奥沙利铂致过敏反应通常发生在多次用药后、化疗10 min内,医护人员若准确判断、迅速停药、及时治疗多不会造成严重后果。

Objective:To discuss the clinical features and management strategies of oxaliplatin-induced allergic reactions.Methods:The medical records of 30 cases of severe oxaliplatin-induced allergic reactions in our hospital from January 2010 to December 2017 were analyzed and their clinical features were summarized.Results:All 30 patients developed allergic reactions after multiple cycles use of oxaliplatin,which happened immediately after or within 10 minutes after the administration.The clinical manifestations mainly included chest tightness,dyspnea,cyanosis of lips,conjunctival congestion and edema,urticaria,fatigue,nausea,vomiting,abdominal pain,shock and so on.One case showed severe thrombocytopenia and haemorrhage.Emergency measures were as follows:Firstly,oxaliplatin was stopped,at the same time the treatment of antihistamine,glucocorticoid,adrenalin and so on was provided.The symptoms would relieve in about 15-30 minutes.Conclusion:Oxaliplatin-induced allergic reactions usually occur either after repeated use of the drug or within 10 min of chemotherapy.If medical staff make accurate judgment,stop the medication immediately and treat it appropriately,it will not cause serious consequences.