难治性肾病综合征大剂量环磷酰胺冲击治疗并发出血性膀胱炎的预防及护理

The prophylactic therapy and nursing of hemorrhagic cystitis after the shock therapy of refractory nephrotic syndrome with large dose of Cytoxan

目的难治性肾病综合征大剂量环磷酰胺冲击治疗，同时给予预防性治疗及护理，对出血性膀胱炎发生率的影响。方法预防性水化治疗及利尿碱化尿液，自配碱化液体，每日补液量2000ml，酌情使用利尿剂，使尿量维持在〉2000ml／d。结果52例病人有3例发生出血性膀胱炎．Ⅰ度2例，Ⅱ度1例，发生率5．8％，低于文献报道的15．6％。结论预防性水化治疗及护理，可降低大剂量应用环磷酰胺并发出血性膀胱炎的发生率。

Objective To discuss the effect of prophylactic therapy and nursing with shock therapy of large dose of Cytoxan in the treatment of refractory nephroitic syndrome. Methods Hydration and diuresis was done, and the urine was alkalinized. Alkaline liquid was prepared and given 2 000 ml per day. Diuretic was given properly to maintain the urinary volume exceeding 2 000 ml per day. Results Only 3 eases of 52 patients occurred hemorrhagic cystitis, 2 cases in degree Ⅰ and 1 case in degree Ⅱ. The incidence rate was 5. 8%, lower than that reported by the articles （ 15.6% ） . Conclusion Prophylactic therapy and nursing can decrease the incidence of hemorrhagic cystitis caused by large dose of Cytoxan.