PDF(Pubmed)
Abstract：
A 65-year-old man was treated with a course of rituximab, cisplatin, and cytarabine. During the second cycle, a volume of 40-50 mL of 0.3 mg/mL cisplatin was extravasated. The patient was treated with a cold pack multiple times a day and cutaneous application of dimethyl sulfoxide cream three times a day for a week. In the months after the extravasation, the patient suffered from worsened swelling and redness and a black crust had formed on the wound. The patient was diagnosed with chemical phlebitis. After watchful waiting for 3 months, antibiotic therapy was started. After 7 months, the wound had healed. On the contrary to what is described in our case, no extravasation guideline classifies cisplatin in a concentration lower than 0.4 mg/ml as a vesicant. The different guidelines also present conflicting recommendations on how to treat the extravasation of cisplatin. In three previous case reports, severe effects of cisplatin extravasation after infusion at low concentration were described as well. We recommend that the findings from our case report are incorporated into extravasation guidelines to ensure optimal treatment of cisplatin extravasations.
摘要：
一名65岁的男子接受了一个疗程的利妥昔单抗治疗，顺铂,和阿糖胞苷.在第二个周期中，有体积为40~50mL的0.3mg/mL顺铂外渗.患者每天多次使用冷敷袋进行治疗，并每天三次皮肤应用二甲基亚砜乳膏，持续一周。在溢出后的几个月里，患者肿胀和发红恶化，伤口上形成黑皮。患者被诊断为化学性静脉炎。经过3个月的观察等待，开始抗生素治疗.7个月后,伤口愈合了。与我们案例中描述的相反，无外渗指南将浓度低于0.4mg/ml的顺铂归类为起泡剂.不同的指南还提出了关于如何治疗顺铂外渗的相互矛盾的建议。在之前的三份病例报告中，还描述了低浓度输注后顺铂外渗的严重影响。我们建议将病例报告的结果纳入外渗指南，以确保顺铂外渗的最佳治疗。
