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目的探讨白血病、恶性淋巴瘤患者化疗后并发急性肿瘤溶解综合征(ATLS)的高危因素、诊断、预防及治疗。方法对9例(白血病7例,淋巴瘤2例)化疗后发生ATLS的患者化疗前后各项生化指标进行分析。结果发生ATLS的高危因素与外周血白细胞数量、骨髓幼稚细胞比例、生化中乳酸脱氢酶有关;ATLS主要表现为高尿酸血症、高钾血症、高磷血症、低钙血症及肾功能损害,并且预后差,死亡率高。2例死亡,1例自动出院,4例及时治疗后完全缓解,2例部分缓解。结论针对可能出现ATLS的患者进行早期预防、早期诊断、早期治疗是改善患者预后的关键。
Objective To investigate the risk factors, diagnosis, prevention and treatment of patients with leukemia and malignant lymphoma complicated with acute tumor lysis syndrome (ATLS) after chemotherapy. Methods The biochemical indexes before and after chemotherapy in 9 cases (7 cases of leukemia, 2 cases of lymphoma) after ATLS were analyzed. Results The risk factors of ATLS were related with the number of leukocytes in peripheral blood, the proportion of immature cells in bone marrow and lactate dehydrogenase in biochemistry. ATLS mainly manifested as hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia and kidney Functional impairment, and poor prognosis, high mortality. Two patients died and one patient was discharged automatically. Four patients were completely relieved in time and two patients were partially relieved. Conclusions Early prevention, early diagnosis and early treatment of patients with possible ATLS are the keys to improve the prognosis of patients.