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一名接受全身照射(TBI)的小儿白血病患者的麻醉挑战:病例报告

Anesthetic Challenges for a Pediatric Leukemia Patient Undergoing Total Body Irradiation (TBI): A Case Report.

作者信息

Butt Mohsin N, Shamim Nazia, Faraz Asma

机构信息

Department of Anaesthesiology, Aga Khan University Hospital, Karachi, PAK.

出版信息

Cureus. 2024 Feb 4;16(2):e53535. doi: 10.7759/cureus.53535. eCollection 2024 Feb.

Abstract

Radiotherapy of the whole body is called total body irradiation (TBI). It is a well-established component of conditioning regimens before stem cell transplantation in juvenile leukemia. The patient was a three-year-old child with a diagnosis of B-cell acute lymphoblastic leukemia and planned for stem cell transplantation. He was given TBI under anesthesia for three consecutive days prior to the bone marrow transplantation under general anesthesia. The important concerns were related to neutropenia/immune suppression, parental consent for repeated anesthesia, nothing per oral guidelines for the TBI treatment, the possibility of high-grade fever, high chance of respiratory tract infections with repeated anesthesia exposure, etc. Proper preparation, teamwork, and collaborative efforts and the child's parents made this treatment possible with intended success.

摘要

全身放疗称为全身照射(TBI)。它是青少年白血病干细胞移植前预处理方案中一个成熟的组成部分。该患者是一名三岁儿童,诊断为B细胞急性淋巴细胞白血病,计划进行干细胞移植。在全身麻醉下进行骨髓移植前,他连续三天在麻醉状态下接受全身照射。重要的关注点包括中性粒细胞减少/免疫抑制、家长对重复麻醉的同意、全身照射治疗的禁食指南、高热的可能性、重复麻醉暴露导致呼吸道感染的高风险等。适当的准备、团队合作以及共同努力,加上孩子父母的配合,使得这次治疗得以成功实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d32/10912886/d49b165976a2/cureus-0016-00000053535-i01.jpg

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