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首页> 外文期刊>Case Reports in Vascular Medicine >Oxaliplatin Induced Digital Ischemia and Necrosis
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Oxaliplatin Induced Digital Ischemia and Necrosis

机译:奥沙利铂诱导的数字缺血和坏死

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Introduction. Digital ischemia is a rare complication of several chemotherapeutic medications. We aimed to present a patient with digital ischemia, secondary to a new generation chemotherapeutic drug, oxaliplatin.Case Report. 62-year-old woman presented to our department with severe pain, paresthesia, and distal acrocyanosis on her right hand fingertips. Her complaints started five days after the third cycle of a chemotherapy protocol consisting of 5-fluorourasil (5-FU), folinic acid, and oxaliplatin due to advanced colon carcinoma. On physical examination, hemorrhagic and partly ulcerative lesions were detected at her right hand fingertips. Radial and ulnar pulses were absent at affected side. Digital subtraction angiography revealed severe vascular resistance in the affected extremity. Iloprost trometamol treatment was started with the dosage of 1 ng/kg/min. In addition, low-molecule-weight heparin was used for preventing possible microemboli. Symptomatic relief was provided after five days, and patient was discharged on 7th day of treatment.Discussion. The pathogenesis of oxaliplatin induced vascular toxicity remains unclear. Endothelial damage, increased adherence of platelets, deposition of immune complexes as an immunologic effect of oxaliplatin, and hypercoagulable state may be the reason for arterial thrombosis, digital microemboli, possible digital ischemia, and their several consequences.
机译:介绍。数字缺血是几种化疗药物的罕见并发症。我们的目的是向患者介绍一种发生在数字化缺血中的,继发于新一代化疗药物奥沙利铂的案例。一名62岁的女性因右手指尖严重疼痛,感觉异常和远端肢端紫cyan而出现在我们科室。由于晚期结肠癌,由5-氟尿嘧啶(5-FU),亚叶酸和奥沙利铂组成的化学治疗方案的第三个周期的第三天开始,她的投诉开始了。体格检查发现右手指尖有出血性和部分溃疡性病变。在患侧没有ial脉和尺骨脉搏。数字减影血管造影显示患肢严重的血管阻力。以1μng/ kg / min的剂量开始使用伊洛前列曲美他莫治疗。另外,低分子量肝素被用于预防可能的微栓塞。五天后症状缓解,治疗后第7天出院。奥沙利铂诱导的血管毒性的发病机制仍不清楚。内皮损伤,血小板粘附增加,作为奥沙利铂的免疫学作用的免疫复合物沉积以及高凝状态可能是动脉血栓形成,数字微栓塞,可能的数字缺血及其原因的原因。

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