Martell R W, Jacobs P
Postgrad Med J. 1986 Oct;62(732):915-8. doi: 10.1136/pgmj.62.732.915.
In a retrospective analysis five of 104 patients with acute leukaemia undergoing cytotoxic chemotherapy developed abdominal signs requiring emergency surgical exploration. Two common features in these patients were the inclusion of cytosine arabinoside in their treatment regimen and a necrotizing lesion involving the terminal ileum, appendix, and right colon. Appendicectomy was performed in two and hemicolectomy in three. Of the patients receiving high-dose cytosine arabinoside one died in the immediate post-operative period and two after recovery from surgery but before marrow regeneration; the remaining two patients received conventional dose cytosine arabinoside, and both recovered. The inclusion of this agent is standard in modern treatment programmes, resulting in significant improvement in long-term disease-free survival, so that a greater awareness of this complication is necessary. Early surgery, utilizing modern support techniques, is recommended as feasible and appears to offer the only realistic chance of survival.
在一项回顾性分析中，104例接受细胞毒性化疗的急性白血病患者中有5例出现腹部体征，需要进行急诊手术探查。这些患者的两个共同特征是治疗方案中包含阿糖胞苷，以及累及回肠末端、阑尾和右结肠的坏死性病变。2例行阑尾切除术，3例行半结肠切除术。接受大剂量阿糖胞苷治疗的患者中，1例在术后即刻死亡，2例在术后恢复但骨髓再生前死亡；其余2例接受常规剂量阿糖胞苷治疗，均康复。在现代治疗方案中，使用这种药物是标准操作，可显著提高长期无病生存率，因此有必要提高对这种并发症的认识。建议采用现代支持技术进行早期手术，因为这是可行的，而且似乎是唯一现实的生存机会。
