长春新碱和长春花碱引起的喉返神经麻痹

来源 :国外医学.耳鼻咽喉科学分册 | 被引量 : 0次 | 上传用户:kongque168
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长春新碱和长春花碱用于治疗急性淋巴母细胞性白血病和淋巴瘤;但这些制剂均有副作用,尤其严重的是神经毒性,尽管通常是可逆的。早期报告曾提及有声嘶,但被人们所忽视。本文介绍3例长春生物碱选择性引起喉神经损害,停药后才恢复功能。这两种药均有神经毒性,成人的毒性作用为儿童三倍,而长春新碱更为有害。最早表现为腱反射消失,继之感觉异常,偶尔有远中端感觉丧失;如不及时停药,会发生远中侧肌无力及萎缩。长春新碱还可能造成植物神经障碍,常见的副作用有便秘,偶尔有尿潴留。Bohannon等(1963)报告35名晚期白血病或淋巴瘤病人在大 Vincristine and vinblastine are used in the treatment of acute lymphoblastic leukemia and lymphomas; however, these agents all have side effects, especially severe neurotoxicity, though usually reversible. Earlier reports mentioned hoarseness, but ignored. This article describes the three cases of vinca alkaloids selectively cause damage to the laryngeal nerve, after stopping the recovery function. Both drugs are neurotoxic, with toxic effects in adults tripling in children and vincristine more harmful. The earliest manifestation of tendon reflex disappeared, followed by the feeling of abnormalities, and occasionally there is loss of distal midrange; if not promptly discontinued, there will be weakness and atrophy distal medial muscle. Vincristine may also cause autonomic dysfunction, common side effects are constipation, occasional urinary retention. Bohannon et al (1963) reported 35 patients with advanced leukemia or lymphoma in large
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