徐万里, 茅爱武, 金涛, 江谋应, 王金林, 严卫国. 动脉灌注化疗患者心电图改变64例分析[J]. 蚌埠医学院学报, 2010, 35(8): 834-836.
    引用本文: 徐万里, 茅爱武, 金涛, 江谋应, 王金林, 严卫国. 动脉灌注化疗患者心电图改变64例分析[J]. 蚌埠医学院学报, 2010, 35(8): 834-836.
    XU Wan-li, MAO Ai-wu, JIN Tao, JIANG Mou-ying, WANG Jin-lin, YAN Wei-guo. Electrocardiogram changes caused by arterial infusion chemotherapy: an analysis of 64 cases[J]. Journal of Bengbu Medical College, 2010, 35(8): 834-836.
    Citation: XU Wan-li, MAO Ai-wu, JIN Tao, JIANG Mou-ying, WANG Jin-lin, YAN Wei-guo. Electrocardiogram changes caused by arterial infusion chemotherapy: an analysis of 64 cases[J]. Journal of Bengbu Medical College, 2010, 35(8): 834-836.

    动脉灌注化疗患者心电图改变64例分析

    Electrocardiogram changes caused by arterial infusion chemotherapy: an analysis of 64 cases

    • 摘要: 目的:通过改变蒽环类抗肿瘤药物经肿瘤供养动脉给药模式的心电图观察,探讨蒽环类抗肿瘤药物的心脏毒性。方法:选择经病理学确诊的中晚期恶性肿瘤88例,化疗方案均为阿霉素+顺铂+氟尿嘧啶,随机分为A、B两组各44例。A组经肿瘤供养动脉主干单纯区域性灌注化疗56次;B组区域性和超选择性相结合、多靶点插管,合理灵活栓塞,小剂量用药和按血供比例灌注联合应用88次。观察2组灌注前及注药后10min、24h、48h的常规12导联心电图的变化。结果:88例患者插管前和插管时心电图均正常。经144次抗肿瘤药物灌注出现心电图改变64例,发生率为44.5%,其中A组心律失常发生率为58.1%,B组为24.2%,2组差异有统计学意义(P<0.01); ≥ 60岁组心律失常的发生率高于50~59岁组(P<0.05)。结论:经肿瘤供养动脉主干单纯区域性灌注化疗者心律失常发生率最高,提示该方法与静脉化疗阿霉素的心脏毒性作用无差异,且多发生于老年人,在介入治疗中应高度警惕。

       

      Abstract: Objective: To discuss the cardiac toxicity of anthracycline by observing the electrocardiogram which recording the routs of administration by arteries providing nutrients to the tumor.Methods: Eighty-eight cases which were pathologically diagnosed as midadvanced malignant tumor were randomly divided into group A and group B (44 cases for each group).The chemotherapy regimen for both groups consisted of adriamycin + cisplatin + fluorouracil.In group A,regional perfusion through main coronary arteries of tumors was used alone for 56 times;in Group B,combined application of perfusion,regionally and super-selectively,with integration of multi-targeted intubation,reasonable and flexible embolization,low-dose of medication and perfusion according to proportion of blood supply,was conducted for 88 times.Infusion chemotherapy and embolization were conducted 144 times altogether.The conventional 12-lead ecg was recorded 10 minutes,24 hours and 48 hours after operation and drug injection.Results: Eighty-eight patients' electrocardiograms were normal during the process of pre-intubation and while-intubation.After conducting anticancer drug perfusion for 144 times,64 cases presented changes of electrocardiograms (44.5%),and the incidence rate of arrhythmia was 58.1% in group A.The difference between the two groups was statistically significant (P<0.01).The incidence of arrhythmia in patients aged above or equal to 60 was higher than that aged between 50 and 59 (P<0.05).Conclusions: Regarding to the two methods of interventional chemotherapy,the incidence of arrhythmia is higher in Group A.That implies that the cardiac toxicity initiated by the method used in Group A is not different from that initiated by the method of intravenous chemotherapy,and such effect occurs frequently among the elderly,which should be highly alerted to in the process of interventional chemotherapy.

       

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