儿童神经母细胞瘤合并心力衰竭1例

A case of neuroblastoma complicated with heart failure in children

报道1例儿童神经母细胞瘤合并心力衰竭并进行可能原因探讨。3岁7个月患儿,起病隐匿,以食欲减退为首发症状,完善腹部影像学及术后病理组织检查,确诊神经母细胞瘤。在近4个月的时间里,先后应用了“环磷酰胺”联合“伊立替康”,“依托泊苷”联合“顺铂”方案,“依托泊苷”联合“奈达铂”方案化疗。经过5个周期化疗后,患儿出现呼吸困难、强迫坐位、面色苍白、紫绀、烦躁等急性心力衰竭表现。对于神经母细胞瘤化疗后并发心力衰竭的报道,临床并不多见,应警惕并关注化疗药物对心脏的毒性作用,早期进行相关检查,改善心功能以改善预后。

One case of neuroblastoma complicated with heart failure in children is reported,and the possible cause was studied.The child patient is 3 years and 7 months old,the onset is occult and anorexia is the first symptom.After abdominal imaging and postoperative histopathological examination,it is diagnosed as neuroblastoma.In the 4 months of treatment,the following chemotherapy regimens have been used in turn:cyclophosphamide combined with irinotecan,etoposide combined with cisplatin,and then etoposide combined with nedaplatin.After 5 cycles of chemotherapy,the child has some symptoms of acute heart failure,including dyspnea,forced sitting position,pallor,cyanosis and irritation.Clinically there have been few reports on heart failure after chemotherapy for neuroblastoma,so we should be alert and pay attention to the toxic effect of chemotherapy medicines on heart,performing related examinations at an early stage in order to improve heart function and the prognosis.