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1例61岁男性急性淋巴细胞白血病患者行化疗药物鞘内注射,因医生配药时拿错药物,误将5%碳酸氢钠注射液用作化疗药物溶媒。鞘内注射完毕后患者即出现下肢麻木,继之出现寒战、高热(体温最高40.1℃)、大汗、血压升高(190~210/106~110 mm Hg,1 mm Hg=0.133 kPa)、心率增快(170~180次/min)、尿潴留。给予甲泼尼龙、甘露醇静脉滴注,同时给予补液及导尿等处理。4 h后患者体温、血压、心率恢复正常,6 h后下肢麻木消失,12 h后可自行排尿。随访1周,患者未再出现类似症状。
A 61-year-old man with acute lymphoblastic leukemia received chemotherapy and intrathecal injection of 5% sodium bicarbonate injection as a chemotherapeutic drug by mistake when he took the wrong drug. After intrathecal injection, the patient developed numbness in the lower extremities, followed by chills, high fever (up to 40.1 ° C), hyperhidrosis, elevated blood pressure (190-210 / 106-110 mm Hg, 1 mm Hg = 0.133 kPa), heart rate Increased (170 ~ 180 times / min), urinary retention. Given methylprednisolone, mannitol intravenous infusion, while giving fluid and catheterization and other treatment. After 4 hours, the patient’s body temperature, blood pressure and heart rate returned to normal. After 6 hours, numbness of the lower extremities disappeared, and voided urine was allowed after 12 hours. Followed up for 1 week, the patient did not appear similar symptoms.