放化疗所致出血性膀胱炎的治疗进展

Chemotherapy and radiatherapy induced haemorrhagic cystitis： current progress of the treatment

出血性膀胱炎（HC）是高剂量放化疗潜在的严重并发症.化疗药物所致的膀胱黏多糖（GAG）层受损及放疗所致的膀胱壁小血管的进行性闭塞是导致HC的重要原因.美司钠、水化、持续性膀胱冲洗是防治HC的常用措施,但效果常不理想.近年来,膀胱GAG层的补充治疗和高压氧治疗获得了一些临床证据支持.但目前尚没有关于处理HC的最佳治疗策略,因此如何预防和治疗放化疗所致的HC仍是目前研究的焦点.

Haemorrhagic cystitis （HC） is a potentially severe complication,caused by high-dose chemotherapeutic drugs or radiation therapy （RT）.It is thought that a defect caused by chemotherapeutic drugs in the glycosaminoglycan （GAG） layer may be the first step in HC development.The pathogenesis of RT-induced cystitis originates as a progressive obliteration of the small blood vessels of the bladder wall.Mesna,hyperhydration and continuous bladder irrigation have been shown effective in preventing HC.However,these preventive protocols do not always satisfactorily protect the patient from bladder injury.In recent years,GAG-replenishment therapy and hyperbaric oxygen therapy have gained some evidence exists.Currently,there is a lack of consensus about the best treatment for patients with chemotherapy and radiatherapy induced HC.Therefore,the prevention and treatment of this complication is still the focus at present.