Elizabeth Mary Durfee is a pediatric acute care nurse practitioner at UCSF Benioff Children's Hospital, Oakland, California.
Crit Care Nurse. 2022 Jun 1;42(3):19-25. doi: 10.4037/ccn2022795.
Tumor lysis syndrome is a life-threatening oncologic emergency in adult and pediatric patients with hematologic cancer. It occurs most often in malignancies with rapid cell turnover and large tumor burden, but its incidence has risen in solid tumors. The subsequent release of tumor cell contents into the bloodstream results in dangerous electrolyte and metabolic disturbances.
To provide acute and critical care nurses with a comprehensive review targeted to critical care nursing practice. Recognition of hallmark signs and symptoms will improve early detection and intervention.
A literature review was performed using the following keywords: tumor lysis syndrome, diagnosis, nursing, early detection, and early diagnosis in PubMed and tumor lysis syndrome, diagnosis, early diagnosis, and early detection in CINAHL. Included studies were published in 2014 or later.
Tumor lysis syndrome causes hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia. These laboratory disturbances can lead to potentially destructive complications including renal injury, arrhythmias, seizures, and neuromuscular instability.
Acute and critical care nurses can use disease-related risk factors and clinical presentations associated with these laboratory derangements to determine the level of monitoring and intervention necessary for impacted patients.
Knowledge of risk factors and clinical presentations will enhance the ability of nurses in clinical practice to prevent adverse events and complications that result from tumor lysis syndrome.
肿瘤溶解综合征是血液系统恶性肿瘤的成人和儿科患者存在的危及生命的肿瘤急症。它最常发生于具有快速细胞更新和大肿瘤负担的恶性肿瘤中，但在实体瘤中其发病率已上升。随后肿瘤细胞内容物释放到血液中会导致严重的电解质和代谢紊乱。
为急性和重症监护护士提供针对重症监护护理实践的综合综述。识别标志性的体征和症状将有助于早期发现和干预。
在 PubMed 中使用以下关键词进行文献回顾：肿瘤溶解综合征、诊断、护理、早期检测和早期诊断，在 CINAHL 中使用肿瘤溶解综合征、诊断、早期诊断和早期检测进行文献回顾。纳入的研究发表于 2014 年或之后。
肿瘤溶解综合征导致高钾血症、高磷血症、低钙血症和高尿酸血症。这些实验室紊乱可导致潜在破坏性并发症，包括肾损伤、心律失常、癫痫发作和神经肌肉不稳定。
急性和重症监护护士可以使用与这些实验室异常相关的疾病相关危险因素和临床表现来确定受影响患者所需的监测和干预水平。
对危险因素和临床表现的了解将提高护士在临床实践中预防肿瘤溶解综合征导致的不良事件和并发症的能力。
