Sommerkamp H
Abteilung für Urologie, Klinikum der Universität Freiburg.
Urologe A. 1998 Sep;37(5):516-21. doi: 10.1007/s001200050211.
Hemorrhagic cystitis is a well known toxic and often life-threatening complication from high-dose chemotherapy with cyclophosphamide. The incidence is particularly high after allogeneic bone marrow transplantation. The morphologic bladder wall changes are associated with gross hematuria, clot formation in the bladder and problems to control the bleeding in up to 70% without preventive measures. Prevention is routinely done and can reduce but not obviate the incidence of hemorrhagic cystitis. Treatment is initiated by forced diuresis and continuous bladder irrigation. When necessary endoscopic cauterisation of bleeding mucosal areas is combined with the instillation of hemostyptic agents. Embolisation of the pelvic vessels or open surgery to control the bleeding is indicated in selected cases in a life-threatening situation.
出血性膀胱炎是高剂量环磷酰胺化疗众所周知的一种毒性且常危及生命的并发症。在异基因骨髓移植后，其发生率尤其高。膀胱壁的形态学改变与肉眼血尿、膀胱内血凝块形成以及在没有预防措施的情况下高达70%的出血控制问题相关。预防措施常规进行，可降低但不能消除出血性膀胱炎的发生率。治疗首先采用强制利尿和持续膀胱冲洗。必要时，对出血黏膜区域进行内镜烧灼，并联合注入止血剂。在危及生命的情况下，对于某些选定病例，可采用盆腔血管栓塞或开放手术来控制出血。
