实体瘤溶解综合征

Tumor lysis syndrome in solid tumors

肿瘤溶解综合征是血液系统肿瘤治疗中常见的并发症,但在实体瘤中较少见,其发病隐匿,极易误诊、漏诊,预后差。实体瘤溶解综合征典型的临床特征为高尿酸血症、高钾血症、高磷血症和低钙血症,并发症主要为急性肾功能衰竭和心律失常。对高危患者进行预防性干预、早期诊断和积极治疗是改善预后的关键。本文回顾既往文献报道的87例实体瘤溶解综合征,对其发病情况、预防和治疗进行综述。

Tumor lysis syndrome（TLS） occurs frequently in the chemotherapy of patients with hematologic malignancies;however,it is rarely reported in solid tumors.Because of the latent incidence,TLS is vulnerable to misdiagnosis or missed diagnosis,leading to a poor prognosis.TLS is characterized by hyperuricemia,hyperkalemia,hyperphosphatemia and hypocalcaemia,with some major complications such as acute renal failure and cardiac arrhythmias.Therefore,the key treatment strategies usually refer to appropriate prophylactic measures for high-risk patients,early diagnosis and aggressive therapy.This paper reviews 87 cases of TLS reported in the English literature and discusses its incidence,prevention and treatment.