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目的探讨膀胱动脉栓塞治疗异基因造血干细胞移植(HSCT)后难治性出血性膀胱炎(HC)的临床疗效。方法 6例接受异基因HSCT的受者在移植后17~49 d发生难治性HC,常规治疗无效后接受膀胱动脉栓塞治疗。栓塞前、后分别留取尿液标本,通过肉眼观察和显微镜检查评定疗效。结果 6例难治性HC患者首次接受膀胱动脉栓塞治疗的中位时间为确诊HC后22 d(5~72 d),其中5例达到治愈标准,肉眼血尿消失时间为栓塞术后3~41 d;1例达到有效标准。其中3例患者接受2次栓塞治疗。6例患者均未出现严重并发症。结论对于出血严重、常规治疗无效的难治性HC,可选择膀胱动脉栓塞治疗。
Objective To investigate the clinical efficacy of bladder artery embolization in the treatment of refractory hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT). Methods Six recipients of allogeneic HSCT developed refractory HC at 17-49 days after transplantation, and were treated with bladder artery embolization after routine treatment was ineffective. Urine samples were taken before and after embolization respectively, and the curative effect was evaluated by macroscopic and microscopic examination. Results The median time of bladder embolization in 6 patients with refractory HC was 22 days (5-72 days) after the diagnosis of HC, of which 5 cases met the standard of cure and the disappearance time of gross hematuria was 3 ~ 41 days after embolization ; 1 case reached the effective standard. Three of these patients received two embolizations. None of the 6 patients experienced serious complications. Conclusion For severe bleeding, conventional treatment ineffective refractory HC, may choose bladder artery embolization.