一例5 - 甲诱导的高氨血和乳酸症,成功用连续血液过透析治疗
Taro Asano1, Narumi Yamada1, Chikaaki Nakamichi1
1Department of Emergency Medicine, National Organization Nagasaki Medical Center, Nagasaki, JPN.
Cureus
|November 28, 2024
概括
在5-fluorouracil (5-FU) 化疗期间改变精神状态可能表明高氨血和乳酸化症. 迅速干预血液净化和支持性护理可以导致癌症患者的神经恢复.
科学领域:
- 在瘤学瘤学.
- 神经科学是一个神经科学.
- 毒理学 毒理学 毒理学
背景情况:
- 上直肠癌的治疗包括化疗方案,如folinic acid,fluorouracil (5-FU) 和irinotecan,可能与aflibercept beta.
- 化疗期间的不良事件需要仔细监测和及时管理,以确保患者的安全和治疗的有效性.
研究的目的:
- 在基于5-FU的化疗期间报告患有晚期直肠癌的患者精神状态变化的病例.
- 要突出可能导致高氨血和乳酸化作为5-FU严重副作用的可能性.
- 强调早期诊断和干预的重要性,包括血液净化,用于管理5-FU诱导的神经毒性.
主要方法:
- 一名患有IVc期上直肠癌的患者接受了化疗.
- 患者的精神状态发生变化,高血和乳酸,可疑是5-FU的副作用.
- 持续的血液过开始治疗.
主要成果:
- 患者的高氨血症,乳酸和意识受损在连续血液过后显著改善.
- 神经症状消失了,患者在稳定的状态下出院.
结论:
- 在5-FU治疗期间意识受损需要测量氨和乳酸水平.
- 早期服用分支链氨基酸和考虑血液净化 (连续血液过) 对于管理5 - FU诱导的高氨血和乳酸性酸症至关重要.
- 即时和有针对性的干预可以导致神经恢复,即使在化学疗法相关的神经毒性严重的情况下.
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