[在患有晚期直肠癌的患者中,一种由5-FU诱导的高氨血病病例]
Akira Ishii1, Shinobu Tomochika, Yasuhiro Fujiwara
1Dept. of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine.
Gan to kagaku ryoho. Cancer & chemotherapy
|February 26, 2026
概括
高剂量的5-fluorouracil (5-FU) 化疗治疗晚期直肠癌可能导致严重的高氨血,导致意识受损. 及时的乳糖治疗有效地使氨水平正常化并改善了症状.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 神经科学是一个神经科学.
背景情况:
- 晚期直肠癌带来复杂的治疗挑战,包括肠道阻塞和形成.
- 术前化疗方案,如FOLFOXIRI加贝瓦西祖马布,用于管理晚期疾病.
- 5-甲 (5-FU) 是基石化疗剂,但潜在的毒性需要仔细监测.
研究的目的:
- 报告一例罕见的严重超血和意识受损的罕见病例,该病例是由高剂量的5-FU诱导的,该病例发生在患有晚期直肠癌的患者身上.
- 为突出诊断挑战和成功管理5-FU诱导的高氨血症.
- 审查有关5-FU相关神经毒性和高氨血的文献.
主要方法:
- 一个74岁的男性患有晚期直肠癌的病例报告.
- 使用FOLFOXIRI加上贝瓦齐祖马布,连续使用5-FU.
- 临床监测,脑电图 (EEG),神经成像和血液氨水平评估.
- 用乳糖治疗高氨血的治疗.
主要成果:
- 患者在5-FU输液中出现意识障碍和发作.
- 在没有先前肝病的情况下检测到高氨水平 (367μmol/L),归因于高剂量的5-FU.
- 施用乳糖很快使氨水平正常化,恢复了意识.
- 随后的机器人辅助手术在管理高氨血症后成功进行.
结论:
- 高剂量的5-FU可以导致严重的超血和脑病变,即使在没有先前存在的肝功能障碍的患者中也是如此.
- 早期识别和及时使用乳糖治疗对于管理5 - FU诱导的高氨血症至关重要.
- 这一案例凸显了在接受高剂量5-FU化疗的患者中监测氨水平的重要性.
更多相关视频
07:06Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
27.8K
07:05Important Endpoints and Proliferative Markers to Assess Small Intestinal Injury and Adaptation using a Mouse Model of Chemotherapy-Induced Mucositis
Published on: May 12, 2019
6.7K
相关概念视频
01:29Drugs for Treatment of Ulcerative Colitis in IBD
577
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
577
01:14Prevention of Further Absorption of Poison
1.3K
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.3K
01:25Assessment of the Rectum and Anus
1.5K
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
1.5K
01:23Urea Cycle
51.0K
The urea cycle describes how liver cells convert ammonia to urea. Ammonia is a toxic waste product of protein catabolism. Land animals must convert ammonia into the less toxic urea which can be safely eliminated by the kidneys through urine. Marine animals excrete ammonia directly, and the surrounding water dilutes the ammonia to safe levels.
51.0K
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
744
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
744