摘要
骨肉瘤是最常见的骨原发恶性肿瘤,占原发骨肿瘤的11.7%[1-3],年发病率约为2~3/100万[1-3]。发病年龄多在青少年时期。好发部位在机体长管状骨的干骺端,最常见发病部位是股骨远端和胫骨近端,其次是肱骨近端。早期临床症状多以局部疼痛为主,夜间痛明显。骨端近关节处可见局部肿大,可有触痛,硬度参差,局部皮温较高,可见静脉曲张,有时可触及异常搏动,可伴有病理性骨折出现[4-7]。
Objective To summarize and analyze the influencing factors and successful rescue process of severe delayed elimination complicated with acute liver and kidney injury after high-dose methotrexate(HDMTX)chemotherapy in an adult osteosarcoma patient,so as to guide the safe and rational use of drugs in the later stage to reduce the incidence of adverse reactions after HDMTX chemotherapy.Methods We collected clinical diagnosis and treatment information,reviewed medical records and retrieved literature database to analyze relevant factors that may cause the abnormal excretion delay of methotrexate(MTX).The successful rescue plan was recorded in detail.Results There was a high risk of delayed elimination in osteosarcoma patients treated with HDMTX,which was related to pre-treatment factors such as hydration,alkalization and urine pH.Conclusions Real-time monitoring of MTX blood concentration(C),detailed laboratory examination and preventive treatment are required to reduce the occurrence.
作者
陈警之
胡宇贤
李海亮
王春楠
牛晓辉
徐海荣
CHEN Jing-zhi;HU Yu-xian;LI Hai-liang;WANG Chun-nan;NIU Xiao-hui;XU Hai-rong(Department of Bone Oncology,Beijing Chaoyang Integrated Traditional Chinese and Western Medicine Emergency Rescue Center,Beijing,100020,China)
出处
《中国骨与关节杂志》
CAS
2022年第5期395-400,共6页
Chinese Journal of Bone and Joint
关键词
甲氨蝶呤
骨肉瘤
排泄延迟
影响因素
Methotrexate
Osteosarcoma
Delayed excretion
Influence factor
