长春瑞滨化疗致麻痹性肠梗阻及重度中性粒细胞缺乏症

1例50岁妇女行右肺上叶黏液腺癌切除术后接受化疗，第1、8天长春瑞滨40mg／d，第2—4天顺铂40mg／d。在接受长春瑞滨治疗后第2天（开始使用顺铂前），患者出现便秘，对症治疗后好转，但在第1周期化疗结束后第7天，症状加重，出现腹痛、腹胀、恶心、呕吐。腹部X线检查示肠梗阻，患者中性粒细胞下降至0×10^9／L。在停用长春瑞滨，给予重组人粒细胞集落刺激因子后，患者未再出现便秘，中性粒细胞上升至16．48×10^9／L。

Paralytic ileus and severe neutropenia after chemotherapy with vinorelbine

A 50-year-old woman was scheduled to receive chemotherapy comprising vinorelbine 40 mg/d on day 1 and 8 in combination with cisplatin 40 mg/d on day 2 -4 after undergoing right upper lobectomy for mucinous adenocarcinoma. On day 2 after vinorelbine therapy （before starting cisplatin therapy ）, the patient developed constipation. After symptomatic treatment, her constipation improved. However, on day 7 after the first cycle of chemotherapy her symptoms aggravated, and abdominal pain and distension, nausea, and vomiting occurred. An abdominal X-ray showed intestinal obstruction. Her neutrophil count decreased to 0 × 10^9/L. Vinorelbine therapy was discontinued, and recombinant human granulocyte colony stimulating factor was given. Her constipation did not recur and her neutrophil count increased to 16.48 × 10^9/L.