中国药物警戒 ›› 2024, Vol. 21 ›› Issue (6): 697-699.
DOI: 10.19803/j.1672-8629.20240055

• 安全与合理用药 • 上一篇    下一篇

膀胱内灌注卡介苗致多器官功能衰竭1例分析

徐钰行1, 弓清梅1,*, 骆宇琛1, 王宗隅1, 张囝2   

  1. 1山西省人民医院,山西医科大学第五临床医学院重症医学科,山西 太原 030012;
    2河津市人民医院急诊科,山西 河津 043300
  • 收稿日期:2024-01-25 出版日期:2024-06-15 发布日期:2024-06-18
  • 通讯作者: *弓清梅,女,硕士,主任医师,重症医学。E-mail: ty_gqm@163.com
  • 作者简介:徐钰行,女,在读研究生,全科医学。
  • 基金资助:
    山西省人民医院“136兴医工程”省级专项配套经费科研项目（2019018）

One case of multiple organ failure caused by intravesical infusion of BCG vaccine

XU Yuhang1, GONG Qingmei1,*, LUO Yuchen1, WANG Zongyu1, ZHANG Jian2   

  1. 1Department of Intensive Care Unit, Shanxi Provincial People’s Hospital/The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan Shanxi 030012, China;
    2Emergency Department of Hejin People’s Hospital, Hejin Shanxi 043300, China
  • Received:2024-01-25 Online:2024-06-15 Published:2024-06-18

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摘要： 目的 关注膀胱灌注卡介苗后引起的并发症,探讨发病机制,为临床应用提供参考。方法 分析膀胱内灌注卡介苗致多器官功能衰竭的病例,查阅文献对此并发症发病率、发病机制、临床表现等进行讨论。结果 该患者经升压、经验性抗感染、抗休克、抗结核、补液等对症治疗后,实验室指标回升,病情好转出院。但患者仍不能排除播散性结核感染的可能,过敏反应也有可能参与其中。结论 虽然大部分患者对膀胱灌注卡介苗耐受性良好,但仍需警惕其发生脓毒血症的可能。

关键词: 卡介苗, 膀胱灌注治疗, 膀胱肿瘤, 多器官功能衰竭, 脓毒血症, 不良反应

Abstract: Objective To explore the pathogenesis of complications arising from bladder instillation of the BCG vaccine in order to provide data for clinical applications. Methods One case of multiple organ failure caused by intravesical instillation of the BCG vaccine was analyzed. Related literature was reviewed while the incidence, pathogenesis and clinical manifestations of this complication were analyzed. Results The patient was discharged from the hospital in better condition after symptomatic treatment, involving blood pressure elevation, anti-infection, anti-shock and anti-tuberculosis medications as well as rehydration. The related laboratory indicators of the patient improved. However, the possibility of disseminated tuberculosis could not be ruled out, and allergic reactions might also be involved, which needed to be studied. Conclusion Although the majority of patients are well tolerant of bladder instillation of the BCG vaccine, clinicians need to be alert to its the risk of sepsis.

Key words: Bacillus Calmette-Guérin, intravesical therapy, bladder cancer, multi-organ failure, sepsis, adverse reaction

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