白血病化疗后并发的急性肿瘤溶解综合征

Acute Tumor Lysis Snydrome Complicated in Leukemia after Chemical Treatment

目的 :探讨急性白血病 (AL)患者在化疗后发生急性肿瘤溶解综合征 (ATLS)的临床特征、促发因素、高危因素及诊断防治的经验教训。方法 :对AL在常规化疗前和化疗中常规进行各项血生化指标检查。结果 :所有病例均有不同项目和不同程度的血生化指标异常 ,主要表现为高钾血症、高尿酸血症、高磷血症和低钙血症以及肾功能异常。 9例发生了ATLS ,其中 1例死于急性肾衰 ,5例死于高血钾所致的心律失常。 3例经早期诊断和及时处理病情好转。结论 :早期诊断、及时给予羟基脲及别嘌呤醇和碱化尿液可防治ATLS。

Objective:To study the clinical characteristics,promotive factors,risky factors in and the experience in the diagnosis and treatment of ATLS in the patients with AL after chemical treatment.Methods: Several routine biochemical tests were carried out in the patients with AL before and during treatments.Results:The main abnormal blood chemical features in all cases were hyperkalemia,hyperuricemia,hyperphosphatemia and hypocalcemia and abnormal function of the kidney.9 cases became ATLS,and among them,1 case died of acute renal failure,5 cases of hyperkalemia, while 3 cases survived as a result of early diagnosis and proper treatments.Conclusion:Early diagnosis and complex treatment with hydroxyurea and zyloprim as well as alkalization of urine may prevent and cure ATLS.