黄仁妮 倪建芬 何向明 王春兰

[摘要] 目的 了解盐酸多柔比星脂质体注射液的不良反应的表现及处理，为安全用药提供帮助。 方法 回顾性分析我科2014年1月～2015年1月27例乳腺癌患者在输注盐酸多柔比星脂质体不良反应的表现。 结果 我科103例患者，其中27例患者在不同的时间发生不良反应，主要表现为胸闷、气促、全身皮疹等，26例经对症处理后继续输注，1例患者因反应严重放弃用药。 结论 盐酸多柔比星脂质体临床数据显示其严重的心脏毒性得到控制，起到减毒、增效的良好效果。但其早期不良反应症状多，严重程度不一，医务人员应密切观察用药反应，提高用药安全。

[关键词] 盐酸多柔比星脂质体；不良反应；护理

[中图分类号] R473 [文献标识码] B [文章编号] 1673-9701（2015）34-0136-03

Observation and nursing of 27 cases of adverse reactions of doxorubicin hydrochloride liposome

HUANG Renni NI Jianfen HE Xiangming WANG Chunlan

Department of Breast Surgery， Zhejiang Cancer Hospital， Hangzhou 312000， China

[Abstract] Objective To investigate the performance and treatment of the adverse reactions of doxorubicin hydrochloride liposome injection and provide assistance for safe medication. Methods Manifestation of the adverse reactions caused by doxorubicin hydrochloride liposome infusion of 27 patients from January 2014 to January 2015 with breast cancer was analyzed retrospectively. Results 103 patients of our department were observed， of which 27 patients had adverse reactions at different times， mainly manifesting as chest tightness， shortness of breath and skin rash. Among them， 26 patients continued infusion after symptomatic treatment and 1 patient gave up medication due to severe reactions. Conclusion Clinical data of doxorubicin hydrochloride liposome show that its severe cardiotoxicity is under control and good toxicity attenuating and synergistic effects are obtained. However， it causes various early adverse reactions with different severity， and therefore medical staffs should observe the medication reactions closely in order to improve medication safety.

[Key words] Doxorubicin hydrochloride liposome； Adverse reaction； Nursing

盐酸多柔比星脂质体注射液即为楷莱注射液，是一种脂质体制剂，盐酸多柔比星为其活性成分，是从波塞链霉菌表灰变种培养液中提取得到，本质为蒽环类细胞毒性抗生素[1]。它不仅可用作一线全身化疗药物，而且可以用作治疗病情有进展AIDS-KS患者的二线化疗药物[2，3]。盐酸多柔比星脂质体注射液其实为盐酸多柔比星被包裹于脂质体中，使单核巨噬细胞不能识别该药物，因而延长其在人体内的半衰期，提高靶向性，降低心脏毒性，提高治疗指数[4]，现已被广泛应用于乳腺癌患者。2014年1月～2015年1月我科使用盐酸多柔比星脂质体的患者中有27例在首次使用时发生不同程度的滴注反应，观察及护理，现报道如下。……