蓝燕;殷锦锦;梅峥嵘;
LAN Yan;YIN Jinjin;MEI Zhengrong;Department of Pharmacy,Key Laboratory for Major Obstetric Diseases of Guangdong Province,The Third Affiliated Hospital of Guangzhou Medical University;Maternal and Child Health Care Family Planning Service Center in Zhanjiang;

• 1:广州医科大学附属第三医院药学部广东省产科重大疾病重点实验室
• 2:湛江市妇幼保健计划生育服务中心药剂科

摘要(Abstract)：

1例36岁恶性卵巢癌患者2021年7月3日于某院行紫杉醇+卡铂+贝伐珠单抗新辅助化疗，化疗3疗程后考虑效果欠佳改为多柔比星+卡铂+贝伐珠单抗化疗3次，合计6次。2021年12月3日患者出现腹腔引流液浑浊呈粪渣样，伴恶臭。腹部CT显示大量气腹，弥漫性腹膜炎改变，考虑肠道穿孔，急诊行剖腹探查术，术中见左侧横结肠近脾曲约20 cm处可见一个沿肠管长轴平行的全层破口，关闭结肠破口，行结肠造口+腹腔粘连松解+腹腔置管引流术。术后抗感染对症治疗44 d后，病情稳定顺利出院。肠穿孔为贝伐珠单抗严重不良反应，该患者肠穿孔的出现与贝伐珠单抗的使用存在时间相关性，肠道穿孔很可能为贝伐珠单抗不良反应。
A 36-year-old patient with ovarian cancer received neoadjuvant chemotherapy of paclitaxel+carboplatin+bevacizumab on July 3,2021.After three courses of chemotherapy,considering the poor effect,chemotherapy was changed to doxorubicin+carboplatin+bevacizumab,a total of 6 times.On December 3,2021,the abdominal drainage fluid of the patient presented turbidity with fecal residue and foul odor.Abdominal CT showed extensive pneumoperitoneum with diffuse peritonitis changes,which suggested intestinal perforation.Emergency exploratory laparotomy was performed,a full-layer tear parallel to the long axis of the bowel was observed at about 20 cm near the splenic flexure of the left transverse colon.The colon laceration was closed,and colostomy,abdominal adhesion release,peritoneal tube drainage was performed.After treatment of 44 days,the patient was on the mend and discharged.Serious gastrointestinal perforation had occurred with bevacizumab.There was a time correlation between the occurence of intestinal perforation and the use of bevacizumab in the patient.This intestinal perforation is likely adverse reaction of bevacizumab.

关键词(KeyWords)： 贝伐珠单抗;不良反应;肠道穿孔
bevacizumab;adverse drug reaction;intestinal perforation

Abstract:

Keywords:

基金项目(Foundation): 广东省医院药学研究基金（2021A29）

作者(Authors): 蓝燕;殷锦锦;梅峥嵘;
LAN Yan;YIN Jinjin;MEI Zhengrong;Department of Pharmacy,Key Laboratory for Major Obstetric Diseases of Guangdong Province,The Third Affiliated Hospital of Guangzhou Medical University;Maternal and Child Health Care Family Planning Service Center in Zhanjiang;

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