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[干细胞移植后患者的重症监护支持]

[Intensive care support of patients after stem cell transplantation].

作者信息

Wrede C E, Holler E

机构信息

1Klinik und Poliklinik für Innere Medizin I, Klinikum der Universität Regensburg, 93042 Regensburg, Germany.

2Abteilung für Hämatologie und internistische Onkologie, Klinikum der Universität Regensburg, 93042 Regensburg, Germany.

出版信息

Intensivmed Notfallmed. 2007;44(3):129-141. doi: 10.1007/s00390-007-0774-x.

Abstract

Within the hematologic therapy procedures, stem cell transplantation (SCT) represents the most extensive and invasive intervention. Those patients have certain risks for several bacterial, viral, as well as fungal infections during the different stages of transplantation. Especially in allogenic transplantation, discrimination of non-infectious, mostly immunologic complications like graft-versus-host reactions or VOD (veno-occlusive disease) is crucial, and often represents a therapeutic challenge. An adequate intensive care therapy of these patients can only be achieved with the knowledge of the specific complications of SCT. This review starts with an overview of the SCT stages with their corresponding infectious and noninfectious complications, followed by the discussion of organ specific pulmonary, renal, cardiac, gastrointestinal, hepatic and neurological complications of stem cell transplantation.

摘要

在血液学治疗程序中,干细胞移植(SCT)是最广泛且侵入性最强的干预措施。这些患者在移植的不同阶段面临多种细菌、病毒以及真菌感染的风险。特别是在同种异体移植中,鉴别非感染性(主要是免疫性)并发症,如移植物抗宿主反应或肝静脉闭塞病(VOD)至关重要,且常常是一项治疗挑战。只有了解SCT的特定并发症,才能对这些患者进行充分的重症监护治疗。本综述首先概述SCT各阶段及其相应的感染性和非感染性并发症,随后讨论干细胞移植的器官特异性肺部、肾脏、心脏、胃肠道、肝脏和神经并发症。

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本文引用的文献

1
Critical care considerations of hematopoietic stem cell transplantation.造血干细胞移植的重症监护考量
Crit Care Med. 2006 Sep;34(9 Suppl):S251-67. doi: 10.1097/01.CCM.0000231886.80470.B6.
2
Neutropenic enterocolitis.中性粒细胞减少性小肠结肠炎
Curr Treat Options Gastroenterol. 2006 Jun;9(3):249-55. doi: 10.1007/s11938-006-0043-2.
3
Major complications following hematopoietic stem cell transplantation.造血干细胞移植后的主要并发症。
Semin Respir Crit Care Med. 2006 Jun;27(3):297-309. doi: 10.1055/s-2006-945530.
7
Advances in prevention and treatment of hepatic disorders following hematopoietic cell transplantation.
Best Pract Res Clin Haematol. 2006;19(2):341-52. doi: 10.1016/j.beha.2005.11.008.

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