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患者男,62岁,缘于一年前无诱因出现咳嗽,咳痰带血并伴胸闷,呼吸困难,行肺CT及支气管镜检查,确诊为左肺上叶中心型小细胞肺癌经三次支气管动脉灌注化疗后,肺内肿块明显缩小,咳嗽,胸闷症状明显缓解。为巩固疗效第四次介入治疗。术中常规用50％泛影葡胺行左支气管动脉。造影,摄片显示肿瘤血管染色,于左支气管动脉内注入丝裂霉素10mg,卡铂400mg,足叶乙甙200mg。造影及注入抗癌药过程中病人肢体活动及感觉均正常。灌注后拔管,局部压迫止血10分钟,加压包扎,安返病房。次日晨病人自觉下肢活动不灵,肌力Ⅰ级,患肢皮肤感觉麻木。头CT回报正常。考虑为化疗药物或造影剂的神经毒副作用所致,予静点地塞米松
The patient was male, 62 years old, due to coughing, coughing, blood and chest tightness, and difficulty in breathing. Lung CT and bronchoscopy were performed for the diagnosis of left upper lobe central small cell lung cancer and three bronchial arteries. After infusion chemotherapy, the lung mass was significantly reduced, and the symptoms of cough and chest tightness were significantly relieved. To consolidate the efficacy of the fourth intervention. Intraoperative routine use of 50% diatrizoate meglumine left bronchial artery. Contrast and radiography showed tumor blood vessel staining. In the left bronchial artery, 10 mg of mitomycin, 400 mg of carboplatin, and 200 mg of acetylcholine were injected. The patient’s limb movements and sensations were normal during angiography and injection of anticancer drugs. After the perfusion, the tube was extirpated, and local compression was used to stop the bleeding for 10 minutes. The pressure was bandaged and the patient returned to the ward. The next morning the patient felt conscious of lower limb activity, muscle strength was grade I, and the affected limb felt numb. Head CT returns are normal. Considering the neurotoxic side effects of chemotherapeutic drugs or contrast agents, pre-medication dexamethasone