造血干细胞移植后急性坏死性胰腺炎一例报告和文献复习  

Acute Necrotizing Pancreatitis Following Hematopoietic Stem Cell Transplantation:a Case Report and Literature Review

作　　者：黄东亚 李强[1] 郭峰 朱晗[2] 蒋奎荣 苗毅 HUANG Dong-ya;LI Qiang;GUO Feng;ZHU Han;JIANG Kui-rong;MIAO Yi(Department of Pancreas Center,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,Jiangsu Province,China;Department of Hematology,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京医科大学第一附属医院胰腺中心,江苏南京210029 [2]南京医科大学第一附属医院血液科,江苏南京210029

出　　处：《罕少疾病杂志》2025年第2期9-11,共3页Journal of Rare and Uncommon Diseases

基　　金：国家自然科学基金(82173206)。

摘　　要：目的探讨异基因造血干细胞移植术(HSCT)后发生急性胰腺炎(AP)的发病机制、危险因素、临床特点和治疗预后,以提高临床对此病的认识。方法回顾性分析1例HSCT引起AP的患者的临床资料及文献复习,对本病的发病机制、危险因素、临床表现、诊断、防治策略以及预后进行分析。结果本例患者,女性,16岁,因急性B淋巴细胞白血病行HSCT,术后33天出现腹痛、恶心和呕吐,伴有血清淀粉酶升高,腹部CT证实了AP的诊断。患者接受了补液、预防性抗感染、营养支持等治疗。患者在住院期间合并了胰腺坏死感染,经过抗感染和经皮置管引流(PCD)治疗后,最终成功出院。结论AP是HSCT的罕见并发症,临床医师应该提高对这一潜在并发症的认识和重视,并探索更有效的预防和治疗策略。Objective To explore the etiology,risk factors,clinical characteristics,and treatment of acute pancreatitis(AP)after allogeneic hematopoietic stem cell transplantation(HSCT)to improve the understanding of this condition in clinical practice.Methods A retrospective analysis of clinical data of a single patient who developed AP after HSCT was conducted.Relevant literature regarding the etiology,risk factors,clinical manifestations,diagnosis,management strategies,and prognosis of HSCT-induced AP was reviewed and analyzed.Results The present case involved a 16-year-old female patient who underwent HSCT for acute B-cell lymphoblastic leukemia.On postoperative day 33,she developed abdominal pain,nausea,and vomiting,accompanied by elevated serum amylase levels.Abdominal CT confirmed the diagnosis of AP.The patient received fluid resuscitation,prophylactic antibiotics,and nutritional support.During hospitalization,she also developed infected pancreatic necrosis,which was successfully managed with antibiotics and percutaneous drainage(PCD)treatment.The patient was eventually discharged with a favorable outcome.Conclusion AP is a rare complication of HSCT,and clinicians should be aware of this potential complication and explore more effective preventive and treatment strategies.

关 键 词：急性胰腺炎 造血干细胞移植 移植物抗宿主病 

分 类 号：R657.5[医药卫生—外科学]