Wagner Jonathan, Arora Sanjay
Department of Emergency Medicine, Keck School of Medicine of the University of Southern California, 1200 North State Street, Room 1011, Los Angeles, CA 90033, USA.
Department of Emergency Medicine, Keck School of Medicine of the University of Southern California, 1200 North State Street, Room 1011, Los Angeles, CA 90033, USA.
Hematol Oncol Clin North Am. 2017 Dec;31(6):941-957. doi: 10.1016/j.hoc.2017.08.002.
Cancer and its therapies may lead to several metabolic emergencies that emergency providers (EPs) should be well-versed in identifying and managing. With prompt recognition and treatment initiation in the emergency department, lives can be saved and quality of life maintained. Most oncologic metabolic emergencies occur in advanced cancer states, but some follow initiation of treatment or may be the presenting syndrome that leads to the cancer diagnosis. This article reviews the 2 most emergent oncologic metabolic diagnoses: tumor lysis syndrome and hypercalcemia of malignancy. A discussion on associated cancers and conditions, pathogenesis and pathophysiology, and management recommendations is included.
癌症及其治疗可能导致多种代谢急症,急救人员(EPs)应熟练掌握这些急症的识别和处理。通过在急诊科迅速识别并开始治疗,可以挽救生命并维持生活质量。大多数肿瘤代谢急症发生在癌症晚期,但有些是在治疗开始后出现的,或者可能是导致癌症诊断的首发综合征。本文回顾了两种最紧急的肿瘤代谢诊断:肿瘤溶解综合征和恶性肿瘤高钙血症。文中还包括了对相关癌症和病症、发病机制和病理生理学以及管理建议的讨论。