本文报道在应用左旋门冬酰胺酶(L-ASP)治疗230例小儿急性淋巴细胞性白血病和Ⅳ期淋巴瘤的过程中,共发生L-ASP相关性严重毒副反应13例(占5.65％)。其中急性坏死性胰腺炎(ANP)6例,糖尿病酮症酸中毒2例,急性喉梗阻2例,L-ASP相关性脑病2例,脑血管栓塞1例。上述毒副反应均表现为起病急,症状重,病势凶险,其中尤以ANP为甚,如不及时进行有效治疗则预后极差。本文总结上述毒副反应的临床特征(症状和辅助检查),早期明确诊断和进行有效治疗的方法,疗效与经验体会。 This article reported in the application of L-asparaginase (L-ASP) treatment of 230 cases of pediatric acute lymphoblastic leukemia and stage Ⅳ lymphoma, a total of L-ASP-related serious side effects occurred in 13 cases (5.65%) . There were 6 cases of acute necrotizing pancreatitis (ANP), 2 cases of diabetic ketoacidosis, 2 cases of acute laryngeal obstruction, 2 cases of L-ASP related encephalopathy and 1 case of cerebrovascular embolism. The above-mentioned toxic and side effects are manifested as acute onset, severe symptoms, dangerous disease, especially in ANP is very, if not timely and effective treatment of poor prognosis. This article summarizes the clinical features (symptoms and laboratory tests), early diagnosis and effective treatment methods, efficacy and experience.