膀胱内灌注卡介苗致多器官功能衰竭1例分析

One case of multiple organ failure caused by intravesical infusion of BCG vaccine

目的关注膀胱灌注卡介苗后引起的并发症,探讨发病机制,为临床应用提供参考。方法分析膀胱内灌注卡介苗致多器官功能衰竭的病例,查阅文献对此并发症发病率、发病机制、临床表现等进行讨论。结果该患者经升压、经验性抗感染、抗休克、抗结核、补液等对症治疗后,实验室指标回升,病情好转出院。但患者仍不能排除播散性结核感染的可能,过敏反应也有可能参与其中。结论虽然大部分患者对膀胱灌注卡介苗耐受性良好,但仍需警惕其发生脓毒血症的可能。

Objective To explore the pathogenesis of complications arising from bladder instillation of the BCG vaccine in order to provide data for clinical applications.Methods One case of multiple organ failure caused by intravesical instillation of the BCG vaccine was analyzed.Related literature was reviewed while the incidence,pathogenesis and clinical manifestations of this complication were analyzed.Results The patient was discharged from the hospital in better condition after symptomatic treatment,involving blood pressure elevation,anti-infection,anti-shock and anti-tuberculosis medications as well as rehydration.The related laboratory indicators of the patient improved.However,the possibility of disseminated tuberculosis could not be ruled out,and allergic reactions might also be involved,which needed to be studied.Conclusion Although the majority of patients are well tolerant of bladder instillation of the BCG vaccine,clinicians need to be alert to its the risk of sepsis.