肿瘤溶解综合征

Ivanka Perčić
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摘要

介绍。肿瘤溶解综合征是一种需要及时识别和治疗的急症。它吗?自发性或治疗性细胞死亡的结果,导致细胞内离子和嘌呤碱代谢产物释放到血液中。病理生理学。特征性代谢紊乱包括高钾血症、高磷血症、高尿酸血症和低钙血症。这些代谢变化可导致肾衰竭、心律失常和癫痫发作。流行病学、分类和风险评估。肿瘤溶解综合征的发生率因肿瘤类型而异,但在血液系统恶性肿瘤中最为常见。根据Cairo - Bishop分类法,肿瘤溶解综合征可分为实验室肿瘤溶解综合征和临床肿瘤溶解综合征。肿瘤溶解综合征的预防措施及治疗。对肿瘤溶解综合征的中高危险患者进行频繁的实验室监测是必须的。预防措施是基于强有力的水合作用和控制血清尿酸水平的药物管理。当临床肿瘤溶解综合征发生时,需要额外的治疗,包括肾脏替代治疗,以纠正代谢紊乱。结论。肿瘤溶解综合征是恶性肿瘤患者潜在的致命并发症。早期识别有风险的患者并采取预防和治疗措施可改善这些患者的预后。
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Tumor lysis syndrome
Introduction. Tumor lysis syndrome is an emergency condition requiring prompt recognition and treatment. It?s a consequence of spontaneous or therapy-induced cellular death leading to the release of intracellular ions and metabolic products of purine bases into the bloodstream. Pathophysiology. The characteristic metabolic derangement comprises hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. These metabolic changes can lead to kidney failure, arrhythmia, and seizures. Epidemiology, classification and risk assessment. The incidence of tumor lysis syndrome varies between different types of tumors, but it is most common in hematologic malignancies. According to Cairo - Bishop Classification, tumor lysis syndrome can be defined as laboratory tumor lysis syndrome and clinical tumor lysis syndrome. Preventive measures and treatment of tumor lysis syndrome. Frequent laboratory monitoring is obligatory in patients with intermediate and high risk of tumor lysis syndrome. Preventive measures are based on vigorous hydration and administration of medication to control serum uric acid levels. When clinical tumor lysis syndrome develops, additional treatment, including renal replacement therapy, is needed for the correction of metabolic disturbances. Conclusion. Tumor lysis syndrome is a potentially fatal complication in patients with suffering from malignancies. Early recognition of patients at risk and administration of prophylactic and therapeutic measures improves outcomes for these patients.
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