胃癌术后奥沙利铂联合替吉奥辅助化疗导致心室电风暴一例

A Case of Ventricular Electrical Storm Causing by Oxaliplatin Combined with Tegafur Chemotherapy in Gastric Cancer

一例胃癌术后采用奥沙利铂联合替吉奥辅助化疗的患者,化疗3次后突发意识丧失,120院前心电监护示室颤,电除颤恢复窦性心律后反复发作室颤和尖端扭转室速,胺碘酮、艾司洛尔等治疗无效,发作前表现心率减慢和QT间期延长,采用异丙肾上腺素和心脏临时起搏等治疗提高心率、缩短QT间期后发作终止,提示氟尿嘧啶类化疗药有恶性心律失常副作用。

A case of gastric cancer with oxaliplatin combined with tegafur chemotherapy, sudden loss of con-sciousness after 3 times chemotherapy. 120 ECG monitoring showed ventricular fibrillation, recur-rent ventricular fibrillation and tip torsion ventricular tachycardia outbreak after electric defibril-lation restoring sinus rhythm. Amiodarone, esmolol and other treatment were ineffective. The pa-tient represented heart rate slower and QT interval delay, using isoproterenol and temporary car-diac pacing treatment to improve heart rate, shorten the QT interval to terminate the episode, sug-gesting that fluorouracil chemotherapy has malignant arrhythmia side effects.