一例小细胞肺癌伴异位综合征患者病例分析

Analysis of a case of small cell lung cancer with ectopic syndrome

目的通过对1例小细胞肺癌伴异位ACTH综合征并发迟发型腹泻患者的临床特点、临床药物治疗过程的分析,探讨治疗方案及合理用药。方法收集患者的临床资料及具体治疗过程,对小细胞肺癌伴异位ACTH综合征患者的个体化药物治疗方案及伊立替康引发的迟发型腹泻低钾血症等进行了文献报道、分析和讨论。结果奥曲肽对异位ACTH综合征的治疗有限;奥曲肽可以对伊立替康引起的迟发型腹泻起到一定程度的预防作用;对于顽固性低钾血症,常规补钾效果不佳,低钾症状亦可危及患者生命。结论临床医生和药师尚缺乏对异位ACTH综合征、顽固性低钾的有效处理手段。

Objective Through the analysis of the clinical characteristics and drug treatment process of a case of small cell lung cancer with ectopic ACTH syndrome complicated with delayed diarrhea,the treatment scheme and rational drug use were discussed.Methods We collected the clinical data and specific treatment process of patients,and reported,analyzed and discussed the individualized drug treatment plan of small cell lung cancer patients with ectopic ACTH syndrome and the delayed diarrhea hypokalemia caused by irinotecan.Results Octreotide has limited therapeutic effect on ectopic ACTH syndrome;octreotide can prevent delayed diarrhea caused by irinotecan to a certain extent;for refractory hypokalemia,the effect of routine potassium supplementation is not good,and hypokalemia can also endanger the life of patients.Conclusion Clinicians and pharmacists are lack of effective treatment for ectopic ACTH syndrome and refractory hypokalemia.