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动脉内(IA)化疗可大大提高局部肿瘤区药物浓度,降低全身毒副反应。虽已知静脉输入顺铂可致周围神经损害及 IA 给药可发生腰骶神经丛损伤,但未见臂丛神经受损的报导。作者报导1例患者,女性38岁,因左肩间隙疼痛10年,加重6个月入院。检查示左肩运动稍受限,但运动和感觉神经正常。摄片、CT 与MRI 见左肱骨关节下区远端有4.5cm 溶骨灶,皮质断裂,但软组织无肿块,活检为 MFH。为准备手术,连续3天静脉输入15mg/m~2ADM,第2天从右股动脉穿刺,在透视引导下插入一5-French Weinberg 导管,尖端位于左胸肩峰动脉近端,将150mg/m~2顺铂溶于3%盐水
Intra-arterial (IA) chemotherapy can greatly increase the local tumor area drug concentration and reduce systemic toxicity. Although it is known that intravenous cisplatin can cause peripheral nerve damage and IA administration can cause lumbosacral plexus injury, no report of brachial plexus injury has been reported. The authors reported 1 case of a woman, 38 years old, admitted to the hospital due to pain in the left shoulder gap for 10 years and an increase of 6 months. Examination showed slightly restricted left shoulder movement, but normal motor and sensory nerves. Radiographs, CT, and MRI showed a 4.5-cm osteolytic lesion at the distal end of the left subtalar articular surface, and the cortex was broken, but there was no mass in the soft tissue. The biopsy was MFH. In order to prepare the operation, 15 mg/m~2 ADM was intravenously injected for 3 consecutive days, and the right femoral artery was punctured on the 2nd day. A 5-French Weinberg catheter was inserted under fluoroscopic guidance. The tip was located on the proximal side of the left thoracic aortic artery and was 150 mg/m. ~2 cisplatin dissolved in 3% saline