膀胱动脉栓塞治疗异基因造血干细胞移植后难治性出血性膀胱炎的临床分析

Bladder arterial embolization for the treatment of refractory hemorrhagic cystitis following hematopoietic stem cell transplantation

目的探讨膀胱动脉栓塞治疗异基因造血干细胞移植（HSCT）后难治性出血性膀胱炎（HC）的临床疗效。方法6例接受异基因HSCT的受者在移植后17—49d发生难治性HC，常规治疗无效后接受膀胱动脉栓塞治疗。栓塞前、后分别留取尿液标本，通过肉眼观察和显微镜检查评定疗效。结果6例难治性HC患者首次接受膀胱动脉栓塞治疗的中位时间为确诊HC后22d（5—72d），其中5例达到治愈标准，肉眼血尿消失时间为栓塞术后3～41d；1例达到有效标准。其中3例患者接受2次栓塞治疗。6例患者均未出现严重并发症。结论对于出血严重、常规治疗无效的难治性HC，可选择膀胱动脉栓塞治疗。

Objective To investigate the clinical efficacy of bladder arterial embolization for refractory hemorrhagic cystitis （HC） following allogeneic hemotopoietic stem cell transplantation （HSCT）. Methods Six patients undergoing HSCT developed refractory HC with an onset time of 17 to 49 days. All patients received the treatment of bladder arterial embolization because of serious hemorrhage that could not he controlled by conservative treatments. The urine specimens reserved before and after embolization respectively were examined by naked eye and microscope to evaluate the efficacy. Results Bladder arterial embolizations were performed for 6 patients from 5 to 72 days after being diagnosed with HC. The HC was cured in 5 patients and the HC improved in l patient. For the patients with response, macroscopic hematuria disappeared 3 to 41 days after the treatments. Three patients were given two bladder arterial embolizations. All procedures were tolerated well and no severe adverse effects were observed. Conclusion Bladder arterial mbolization seems to be a safe and effective treatment for refractory HC following HSCT.