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目的探讨栓塞治疗在异基因造血干细胞移植(allo-HSCT)术后重度出血性膀胱炎(HC)中的应用价值。方法6例接受allo-HSCT的患者在移植后24~80d发生重度(Ⅲ~Ⅳ度)HC,经保守治疗无效,在数字减影血管造影(DSA)下行选择性双侧髂内动脉脏支栓塞术治疗。结果6例患者共行8次栓塞治疗,4例治愈,1例好转,1例无效,有效率达83%。4例治愈的患者肉眼血尿消失时间为栓塞术后7~10d,镜下血尿消失时间为栓塞术后20~30d。6例患者均未出现严重并发症。结论应用选择性双侧髂内动脉栓塞治疗重度HC是一种安全有效的措施,是治疗allo-HSCT后难治性、迁延不愈的重度HC的一种新的治疗手段。
Objective To investigate the clinical value of embolization in the treatment of severe hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Six patients with allo-HSCT underwent severe (Ⅲ ~ Ⅳ) HC at 24 ~ 80 d after transplantation. After conservative treatment, 6 patients underwent DSA with selective bilateral internal iliac artery embolization Surgery. Results Six patients underwent embolization eight times in total, four were cured, one was improved, one was ineffective and the effective rate was 83%. Four cases of cured patients with gross hematuria disappeared time after embolization 7 ~ 10d, microscopic hematuria disappeared 20 ~ 30d after embolization. None of the 6 patients experienced serious complications. Conclusion Selective bilateral internal iliac artery embolization for the treatment of severe HC is a safe and effective measure and is a new treatment for refractory and prolonged unhealed severe HC after allo-HSCT.