单倍体造血干细胞移植患者出血性膀胱炎的防治策略  

Prevention and treatment of hemorrhagic cystitis in haploidentical with hematopoietic stem cell transplantation

作　　者：王智明[1] 王琳[1,2] 陈晓霞[1] 徐丹丹[1] 罗贤生[1] 李兴[1] 何丽莉[1] 王云英[1] 符容香[1] 黄姿英[1] 黎丽琼[1] 谭莲[1] 雷美清[1] 

机构地区：[1]海南省海口市人民医院血液科,570208 [2]海南省农垦总局医院血液肿瘤科

出　　处：《中国医药》2010年第7期619-621,共3页China Medicine

基　　金：基金项目：海南省自然科学基金项目（30869）

摘　　要：目的 探讨单倍体造血干细胞移植出血性膀胱炎的防治策略.方法 回顾性分析对8例恶性血液病患者行单倍体造血干细胞移植时防治出血性膀胱炎的方法及疗效.结果 本组8例中无一例发生早期出血性膀胱炎,2例发生迟发性出血性膀胱炎,其中Ⅰ度1例,Ⅱ度1例,分别发生于＋32 d及＋37 d（回输干细胞后为＂＋＂）.2例患者均有程度不等的尿频、尿急、尿痛症状.检测血清巨细胞病毒IgM均阴性.2例患者经水化、强迫利尿、碱化尿液、阿昔洛韦抗病毒、酚磺乙胺静脉滴注及黄酮哌酯解痉,其中1例输注血小板（患者当时血小板为20×109/L）,经上述处理后症状渐好转至痊愈.结论 充分水化,碱化尿液,加强利尿,使用美司钠及抗病毒药预防及治疗出血性膀胱炎具有明显的疗效.Objective To study the prevention and treatment of hemorrhagic cystitis（HC） in haploidentical with hematopoietic stem cell transplantation （HSCT） patients. Methods In 8 hematopoietic malignancy patients with haploidentical HSCT, we adopted adequate hydration and alkalization, enhanced diureses, administration of mesna and antiviral drugs to prevent and treat HC, and then analyzed the effect. Results Two cases showed delayed hemorrhagic cystitis, and recovered with combined treatment include adequate hydration and alkalization, diureses, administration of mesna and antiviral drugs. Conclusion It is an effective prevention and treatment of HC in allogenic hematopoietic ste cell transplantation by combined use of adequate hydration, alkalization, diureses, administration of mesna and antiviral drugs.

关 键 词：出血性膀胱炎 造血干细胞移植 单倍体 美司钠 

分 类 号：R694[医药卫生—泌尿科学]