背景:在Sintilimab治疗中偶尔会出现免疫相关的不良事件。本研究报告了输注Sintilimab后沿静脉的正向和反向肿胀病例。目前,外周输注过程中沿血管方向的肿胀在国内外报道有限,尤其是当选择一条粗脉时,弹性,良好的血液回流。
方法:一名56岁男性,患有食管癌和肝癌,接受白蛋白结合型紫杉醇和奈达铂化疗联合Sindilimab免疫治疗后出现血管肿胀。患者被穿刺3次。
方法:Sintilimab诱发的血管水肿可能是由多种变量共同作用引起的副作用,例如患者的血管功能相对较差,化学外渗,过敏性皮肤反应,静脉瓣膜,血管内膜,和直径狭窄。只有当药物过敏反应是潜在因素时,辛替利玛才很少引起血管水肿。由于只有少数病例报道了由Sintilimab引起的血管水肿,这种药物诱导的血管水肿的原因尚不清楚.
方法:由静脉专科护士根据延迟外渗治疗和医生抗过敏治疗控制肿胀,但是反复穿刺和症状诊断的不确定性给患者及其家人带来了痛苦和焦虑。
结果:经抗过敏治疗后,肿胀症状逐渐缓解。患者在第三次穿刺后无不适地完成了以下药物输注。当病人第二天出院时,他的双手肿胀消失了,患者没有焦虑或不适。
结论:免疫治疗的副作用可能会随着时间的推移而积累。早期识别和适当的护理管理是减少患者痛苦和焦虑的关键。为了有效治疗症状,护士可以从快速确定肿胀的来源中受益。
BACKGROUND: Immune-related adverse events are occasionally reported in Sintilimab treatment. This study
reports a forward and reverse swelling
case along the vein after infusion of Sintilimab. At present, swelling along the vascular direction during peripheral infusion are limitedly reported at home and abroad, especially when choosing a vein with thick, elastic, and good blood return.
METHODS: A 56-year-old male who suffered from esophageal cancer and liver cancer and received albumin-bound paclitaxel and nedaplatin chemotherapy in combination with Sintilimab immunotherapy appeared swelling along the vessel after infusion of Sintilimab. The patient was punctured 3 times.
METHODS: Sintilimab-induced vascular edema may be a side effect resulted from a combination of variables such as relatively poor vascular function of the patient, chemical extravasation, allergic skin reactions, venous valves, vascular intima, and diameter stenosis. Sintilimab rarely causes vascular edema only when drug allergic reaction is the underlying factor. As only a few cases of vascular edema caused by Sintilimab have been reported, causes to such a drug-induced vascular edema remained unclear.
METHODS: The swelling was controlled by an intravenous specialist nurse according to delayed extravasation treatment and the doctor anti-allergy treatment, but the uncertainty of repeated puncture and symptom diagnosis caused pain and anxiety to the patient and his family.
RESULTS: The symptom of swelling was gradually relieved after the anti-allergic treatment. The patient completed the following drug infusion without discomfort after the third puncture. When the patient was discharged the next day, swelling in his both hands disappeared, and the patient had no anxiety or discomfort.
CONCLUSIONS: The side effects of immunotherapy may accumulate over time. Early identification and appropriate nursing management are the keys to minimizing patients\' pain and anxiety. To effectively treat symptoms, nurses could benefit from quickly identifying the source of swelling.