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目的:探讨常规预防方案干预下,造血干细胞移植后出血性膀胱炎(hemorrhagiccystitis,HC)的发病情况、危险因素和有效的防治方法。方法:62例恶性血液病患者(自体移植32例,异基因移植30例),移植过程中均进行常规的HC和移植物抗宿主病(graftversushostdisease,GVHD)预防。分析移植后HC发生的特点及与移植类型、其他临床特征的关系和防治效果。结果:共6例发生HC(9.68%),均为异基因移植患者。平均发病时间为46.50天,平均病程为42.50天。4例发生巨细胞病毒(cytomegalovirus,CMV)感染,其中3例合并GVHD,另有1例仅出现GVHD。经治疗后3例完全缓解,2例部分缓解,1例行膀胱切除术。结论:在采取充分的预防措施后,HC多为晚期发生,可能与异基因移植、GVHD和CMV感染有关,病程迁延、部分难治。
Objective: To investigate the incidence of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation and the risk factors and effective prevention and treatment methods under the intervention of routine prevention programs. Methods: Sixty-two patients with hematologic malignancies (autograft in 32 and allogeneic in 30) were treated with conventional HC and graft-versus-host disease (GVHD). Analysis of the characteristics of HC after transplantation and its relationship with the type of transplantation and other clinical features and prevention and treatment. Results: A total of 6 cases of HC (9.68%) were allogeneic transplantation patients. The average onset time was 46.50 days, the average duration of 42.50 days. 4 cases of cytomegalovirus (cytomegalovirus, CMV) infection, of which 3 cases with GVHD, another case of only GVHD. After treatment, 3 cases were completely relieved, 2 cases partially relieved, and 1 case underwent cystectomy. Conclusion: After taking adequate precautionary measures, HC mostly occurs late, which may be related to allogeneic transplantation, GVHD and CMV infection. The course of disease is prolonged and some are refractory.