弥漫大B细胞淋巴瘤合并高钙危象的诊断与治疗

The diagnosis and treatment of diffuse large B cell lymphoma with hypercalcemic crisis:a case report and review of the literature

目的:总结合并高钙血症弥漫大B 细胞淋巴瘤患者的诊断与治疗经验。方法:收治合并高钙血症的弥漫大B细胞淋巴瘤患者1 例,对其临床资料进行回顾性分析。结果:患者经左髋部骨质穿刺活检病理明确诊断后行R-DA-EPOCH 方案化疗,化疗期间予以水化、碱化尿液、保肝、护胃、止吐及加强血气分析监测等处理,化疗过程顺利,治疗后患者复查血钙及血肌酐恢复至正常范围,头面部及背部软组织包块消失。随访过程中患者规律化疗,未再出现高钙血症及急性肾损伤。结论:弥漫大B 细胞淋巴瘤合并高钙血症确诊依靠病理结果,该病预后差,需早期针对原发病治疗。

Objective:To summarize the experience of diagnosis and treatment of diffuse large B cell lymphoma with hypercalcemia.Methods:The clinical data of 1 patient with hypercalcemia and the diffuse large B cell lymphoma were reviewed and analyzed.Results:Chemotherapy with R-DA-EPOCH regimen was performed in patients with definite pathological diagnosis of left hip bone puncture biopsy.During chemotherapy,hydration,alkalization of urine,liver protection,stomach protection, antiemetic treatment and strengthening blood gas analysis and monitoring were given.The chemotherapy was successful.After treatment,the blood calcium and creatinine were rechecked to the normal range,and the soft tissue of the head and back disappeared.During the follow-up,patients received regular chemotherapy,and no hypercalcemia and acute renal injury occurred. Conclusion:The diagnosis of diffuse large b-cell lymphoma with hypercalcemia depends on pathology results,the prognosis of this disease is poor,and early treatment is needed.