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在收治的肾病综合征患者中,有12例因使用烷化剂而致出血性膀胱炎。12例中肾病综合征I型10例,II型2例。所用烷化剂均为环磷酰胺,均发生在用环磷酰胺总量超过4g时,在用药20天后出现肉眼血尿,其中9例合并尿痛、尿急、尿频,4例有排尿困难。出现肉眼血尿后立即停用环磷酰胺,加用氨己酸5 g静滴,继之以1g/h维持并嘱病人多饮水,11例患者血尿在2日内消失,另1例病人在加用垂体后叶素24小时后消失。将环磷酰胺直接注入膀胱并不引起炎症,而其代谢产物丙稀醛可致膀胱粘膜出血、水肿和溃烂。膀胱病变程度与药物用量有关。本组出血性膀胱炎发生率较高可能与采用每日静注有关。对使用烷化剂过程中出现血尿,伴尿路刺激症状及排尿困难,尿沉渣镜检红细胞形态呈均一性,并通过相应检查排
Among the patients with nephrotic syndrome who were treated, 12 had hemorrhagic cystitis due to alkylating agents. 12 cases of nephrotic syndrome in type I 10 cases, type II in 2 cases. All alkylating agents used were cyclophosphamide, which occurred when the total amount of cyclophosphamide was more than 4g. Gross hematuria occurred after 20 days. Nine patients had dysuria, urgency and frequent urination, and four had dysuria. Cyclophosphamide was discontinued immediately after gross hematuria, plus 5 g intravenous amino acid followed by 1 g / h to maintain and urge the patient to drink more water, 11 patients hematuria disappeared within 2 days, the other patients were added Pituitrin disappeared after 24 hours. Injection of cyclophosphamide directly into the bladder does not cause inflammation, and its metabolite, aldehydes, causes hemorrhage, edema and ulceration of the bladder mucosa. The degree of bladder disease and drug usage. The higher incidence of hemorrhagic cystitis in this group may be related to the use of daily intravenous injection. Hematuria, urinary tract irritation and dysuria were observed in the process of using alkylating agent. Urine sediment microscopy showed that the morphology of erythrocytes was homogeneous,