Çiftçi Ahmet Çağrı, Küpeli Serhan, Sezgin Gülay, Bayram İbrahim
Department of Pediatric Oncolog/Pediatric Bone Marrow Transplantation, Çukurova University, Faculty of Medicine, Adana, Turkey.
Turk J Pediatr. 2018;60(6):660-668. doi: 10.24953/turkjped.2018.06.006.
Çiftçi AÇ, Küpeli S, Sezgin G, Bayram İ. Evaluation of pediatric patients with an oncologic emergency: Single center experience. Turk J Pediatr 2018; 60: 660-668. In this study, we aimed to prospectively analyze the emergency diagnosis and clinical characteristics of the oncologic emergency patients admitted, as well as to evaluate the approach considerations to the cases, their treatment, patient outcomes and the prognostic factors. A total of 88 oncologic emergency patients (90 oncologic emergency hospitalizations), except for febrile neutropenia, were admitted to the pediatric oncology department between July 2014 and December 2015. A total of 30 cases of tumor lysis syndrome, 19 hyperleukocytosis, 11 convulsion, 7 spinal cord compression, 7 hemorrhagic cystitis, 9 pleural effusion, 6 vena cava superior syndrome, 4 typhlitis, 3 anuria, 4 gastrointestinal bleeding, 3 hypercalcemia, 4 acute respiratory distress syndrome, 2 acute massive hepatomegaly and 1 increased intracranial pressure were identified. Sixty-five (72.2%) of the study patients had a primary oncologic disease, whereas 25 (27.8%) had a recurring condition. The most common presenting complaint was fever (23.3%) followed by breathing difficulties (22.2%). Fifty-nine patients (65.6%) recovered and were discharged home, while 31 cases (34.4%) died. Tumor lysis syndrome was the most frequently encountered emergency condition in the pediatric oncology patient group. Oncologic emergencies need to be approached quickly and systematically in the light of current scientific knowledge.
奇夫特西 AÇ、库佩利 S、塞兹金 G、巴伊拉姆 İ。肿瘤急症儿科患者的评估:单中心经验。《土耳其儿科学杂志》2018 年;60: 660 - 668。在本研究中,我们旨在前瞻性分析收治的肿瘤急症患者的急诊诊断和临床特征,以及评估对这些病例的处理考量、治疗、患者结局和预后因素。2014 年 7 月至 2015 年 12 月期间,共有 88 例肿瘤急症患者(90 次肿瘤急症住院),不包括发热性中性粒细胞减少症,被收治到儿科肿瘤科。共识别出 30 例肿瘤溶解综合征、19 例高白细胞血症、11 例惊厥、7 例脊髓压迫、7 例出血性膀胱炎、9 例胸腔积液、6 例上腔静脉综合征、4 例盲肠炎、3 例无尿、4 例胃肠道出血、3 例高钙血症、4 例急性呼吸窘迫综合征、2 例急性大量肝肿大和 1 例颅内压升高。65 例(72.2%)研究患者患有原发性肿瘤疾病,而 25 例(27.8%)患有复发性疾病。最常见的主诉是发热(23.3%),其次是呼吸困难(22.2%)。59 例患者(65.6%)康复并出院回家,而 31 例(34.4%)死亡。肿瘤溶解综合征是儿科肿瘤患者组中最常遇到的急症情况。需要根据当前科学知识迅速且系统地处理肿瘤急症。