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1 病例介绍 患者男,65岁,左下肢疼痛伴跛行。1997年1月,经纤支镜、胸部CT及骨胳ECT显像诊断为左支气管肺腺癌伴多发性骨转移(右肩胛骨下角、右第9,11后肋、右骶髂关节、左髋臼,左股骨头),未治疗。1997年4月初病人左下肢疼痛加重,卧床不起,1997年4月9日静脉滴注帕米膦酸钠(博宁,深圳海王药业有限公司生产)60mg后,第3天病人骨痛消失,能行走,但在用药后第2天开始出现神经精神症状,表现为痴笑、烦躁、易怒、多言,无目的走动、定向错误,给予安定及氯丙嗪后症状稍控制,至用药后第10天症状完全消失。之后给病人用丝裂霉素,长春地辛、顺氯氨铂联合方案化疗2周,情况稳定,生活自理。7月1日病人又出现左下肢疼痛,影响走路,7月7日再次静脉滴注帕米膦酸钠(阿可达,瑞士诺华制药有限公司生产)60mg,骨痛逐步缓解,同样用药第2天出现上述精神症状,但较轻,用安定
1 case description Patient male, 65 years old, left lower extremity pain with claudication. January 1997, bronchoscopy, chest CT and bone ECT imaging diagnosis of left bronchial lung adenocarcinoma with multiple bone metastases (right scapular angle, the right after the 9,11 rib, right sacroiliac joint, left hip Mortar, left femoral head), untreated. In early April 1997 patients with lower extremity pain worsened bedridden, April 9, 1997 intravenous infusion of pamidronate (Bonin, Shenzhen Neptune Pharmaceutical Co., Ltd. production) 60mg, the first three days of patients with bone pain disappeared , But can walk, but in the first 2 days after treatment began to appear neuropsychiatric symptoms, manifested as silly, irritability, irritability, say more, aimless ambulation, orientation error, giving stability and chlorpromazine slightly controlled symptoms, to the medication The symptoms disappeared completely on the 10th day. After the patients with mitomycin, vindesine, cisplatin combination chemotherapy for 2 weeks, the situation is stable, take care of themselves. On July 1, the patient developed left lower extremity pain and affected his walking. On July 7, intravenous infusion of pamidronate (Ahuda, produced by Novartis Pharmaceutical Co., Ltd., Switzerland) 60 mg resulted in a gradual relief of pain. On the same day 2 The above mental symptoms occur, but lighter, with stability