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1例63岁女性结肠癌患者术后采用伊立替康+奥沙利铂化疗方案:首日给予伊立替康200 mg+奥沙利铂200 mg,第8天给予伊立替康160 mg。化疗第7天患者出现黄色稀便,遂停止化疗,给予保护肠黏膜和止泻药。第8天夜间患者发热(体温38.0℃),外周血白细胞计数0.27×10~9/L,血小板计数117×10~9/L,给予抗感染和升白细胞治疗。第14天再次出现严重水样便,当日血钾2.3 mmol/L、钠126 mmol/L,给予抗感染和纠正电解质紊乱治疗。第16天患者出现持续发热、严重腹胀合并肠麻痹,外周血白细胞计数0.25×10~9/L,血小板计数25×10~9/L,给予亚胺培南/西司他丁钠与奥曲肽。第18天患者血压降至70/40 mmHg(1mmHg=0.133 kPa),血氧饱和度测不到,呈昏迷状态。第19天患者经抢救无效死亡。
A 63-year-old woman with colorectal cancer was treated with irinotecan plus oxaliplatin followed by irinotecan 200 mg plus oxaliplatin 200 mg on the first day and irinotecan 160 mg on day eight. Chemotherapy on the 7th day patients with yellow loose stools, then stop chemotherapy, to protect the intestinal mucosa and antidiarrheal drugs. On the 8th day, patients were fever (body temperature 38.0 ℃), peripheral blood leukocyte count was 0.27 × 10 ~ 9 / L and platelet count was 117 × 10 ~ 9 / L. Anti-infection and leukocyte treatment were given. Severe watery stool appeared again on the 14th day, the same day serum potassium 2.3 mmol / L, sodium 126 mmol / L, given anti-infective and electrolyte imbalance treatment. On the 16th day, the patients experienced persistent fever, severe abdominal distension with intestinal paralysis, peripheral blood leukocyte count 0.25 × 10 ~ 9 / L, platelet count 25 × 10 ~ 9 / L, and imipenem / cilastatin sodium and octreotide. On day 18, the patient’s blood pressure dropped to 70/40 mmHg (1 mmHg = 0.133 kPa), and blood oxygen saturation was undetectable and was unconscious. On the 19th day, the patient died of an invalid treatment.