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| Early diagnosis and operational reserarch of tumor lysis syndrome after c-TACE operation for massive hepatocellular carcinoma |
| MA JingPing1, LI Jiaxiang2, QIU Fang3, TAN Yongcai2 |
1. ZhuZhou HuiJia Cancer Hospital, Hunan Zhuzhou 412000, China;
2. JinShaZhou Hospital Of Guangzhou University Of Chinese Medicine, Guangzhou 510000, China;
3. Guangdong College of pharmacy attached three Hospital, Guangzhou 510000, China |
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Abstract Objective To investigate the clinical early diagnosis and operational reserarch of tumor lysis syndrome (TLS) after c-TACE operation on patients with primary massive hepatocellular carcinoma. Methods The clinical data of 11 patients with primary massive hepatocellular carcinoma c-TACE complicated by tumor lysis syndrome operation from August 2016 to May 2021 were collected for retrospective analysis. Results All the 11 patients developed TLS within 72h after operation, accompanied by hyperuricemia in 11 cases (100%), hyperkalemia in 9 cases (81.8%), hyperphosphatemia in 8 cases (72.7%), hypocalcaemia in 4 cases (36.3%), increased creatinine in 4 cases (36.3%), and elevated lactate dehydrogenase in 11 cases. The main clinical manifestations are nausea, vomiting, chest tightness, wheezing, reduced urine volume, edema, tetany, most patients after timely replenishing hydration, correcting electrolyte disorders, reducing uric acid, hemodialysis and other treatment, abnormal indicators are most restored to the normal range within 1 week; One case died without treatment; One case died of acute renal failure, abnormal coagulation function and intracranial hemorrhage. Conclusion Patients with massive hepatocellular carcinomar are prone to TLS in the early postoperative period of c-TACE, TLS is a highly fatal disease, and laboratory indicators such as blood electrolytes, uric acid, renal function and urine output should be closely monitored during treatment. If diagnosed in time and effective therapeutic measures are implemented, the incidence of TLS and mortality can be reduced.
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Received: 11 January 2023
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[1] 姜晓雷. 254例原发性肝癌TACE治疗的回顾性分析研究[J]. 当代医学, 2020, 26(21): 127-128.
[2] 朱鸷翔, 沈松鹤, 赵森, 等. 中晚期原发性肝癌TACE介入微创治疗的疗效和对肝功能的影响[J]. 黑龙江医学, 2020, 44(11): 1483-1485.
[3] 蒋理, 金玲, 杨菁, 等. 儿童血液系统肿瘤并发症肿瘤溶解综合征40例病例系列报告[J]. 中国循证儿科杂志, 2020, 15(5): 370-373.
[4] 王京艳, 周霖, 余强, 等. 肝细胞癌介入治疗术后并发肿瘤溶解综合征的诊断及治疗 (附9例报告)[J]. 山东医药, 2020, 60(30): 54-56.
[5] 国家卫生健康委办公厅. 原发性肝癌诊疗指南 (2022年版)[J]. 临床肝胆病杂志, 2022, 38(2): 288-303.
[6] Cairo MS, Bishop M.Tumour lysis syndrome: new thera- peutic strategies and classification[J]. Br J Haematol, 2004, 127(1): 3-11.
[7] 郑志海, 陈碧云, 廖丽昇, 等. 血液系统恶性肿瘤并发肿瘤溶解综合征的临床特征和影响因素[J]. 中国当代医药大学, 2022, 29(26): 99-102.
[8] Ho M, Zanwar S, Duggan P, et al.Hiding in (not so) plain sight: Spontaneous tumor Lysis syndrome due to intravascular large B cell lymphoma[J]. Am J Hematol, 2022, 97(1): 151-159.
[9] Firwana BM, Hasan R, Hasan N, et al.Tumor lysis syndrome: a systematic review of case series and case reports[J]. Postgrad Med, 2012, 124(2): 92-101.
[10] 张玉盼, 张雅敏. 原发性肝癌肿瘤溶解综合征的病因及治疗进展[J]. 实用器官移植电子杂志, 2015, 3(4): 253-256.
[11] Zivin SP, Elias Y, Ray CE Jr.Tumor lysis syndrome and primary hepatic malignancy: case presentation andreview of the literature[J]. Semin Intervent Radiol, 2015, 32: 3-9.
[12] Matuszkiewicz-Rowinska J, Malyszko J.Prevention and Treatment of Tumor Lysis Syndrome in the Era of Onco-Nephrology Progress[J]. Kidney Blood Press Res, 2020, 45(5): 645-660.
[13] Durani U, Shah ND, Go RS.In-Hospital Outcomes of Tumor Lysis Syndrome: A Population-Based Study Using the National Inpatient Sample[J]. Oncologist, 2017, 22(12): 1506-1509.
[14] Jones GL, WiLL A, Jackson GH, et aL. GuideLines for themanagement of tumour Lysis syndrome in aduLts and chiLdren with haematoLogicaL maLignancies on behaLf of the British Committee for Standards in HaematoLogy[J]. Br J HaematoL, 2015, 169(5): 661-671.
[15] Jiang RD, Jian WC, Jin N, et a1. Tumor lysis syndrome: a serious complication of transcatheter arterial ehemoem- bolization for hepatocellular carcinoma[J]. Am J Med, 2016, 129(9): e173-e176.
[16] 姜亚楠, 赵志刚. 肿瘤溶解综合征的预防和诊治[J]. 临床内科杂志, 2018, 35(9): 593-595.
[17] 叶启翔, 王嘉怡. 肿瘤溶解综合征在儿童恶性肿瘤的诊治进展[J]. 中国小儿血液及肿瘤杂志, 2017, 22(5): 277-280.
[18] 陈辉, 陈森. 拉布立酶防治肿瘤溶解的新进展[J]. 中国现代医药杂志, 2020, 22(6): 104-108.
[19] 张晶樱, 汤永民. 拉布立酶治疗肿瘤溶解综合征相关高尿酸血症临床进展[J]. 中国小儿血液与肿瘤杂志, 2020, 25(4): 239-241+245.
[20] 李涛. 肝癌治疗应重视——肿瘤溶解综合征[J]. 外科理论与实践, 2018, 23(3): 214-216.
[21] 李阳, 张雅敏, 侯建存. 原发性肝癌 TACE 术后急性肿瘤溶解综合征一例[J]. 天津医药, 2017, 45(3): 318-319. |
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2023, Vol. 20 
