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目的临床研究和分析急性肿瘤溶解综合征（ATLS）6例。方法总结自1991年1月至1998年12月间ATLS6例的一般情况、临床和实验室检查特点及治疗。结果6例病人均为淋巴组织恶性病（3例为ALL－L2，3例为NHL）ALL者骨髓增生极度活跃，NHL者均为Ⅲ－Ⅳ期B组且为大细胞高度恶性。化疗前4例患者即出现ATLS的代谢异常。应用的化疗方案除细胞毒药物外均含有激素。化疗后ATLS分别出现在2～7天。ATLS的主要表现有恶心、呕吐、少尿、心慌、胸闷、乏力、大汗等。ATLS的实验室检查异常主要有高血钾（6／6）、高尿素氮（6／6）、代谢性酸中毒（6／6）、高尿酸（3/5）、高血糖（3／6）、低血钙（2／2）、高血磷（1／2）高血镁1／2等。经积极抢救（水化、碱化尿液，减少尿酸生成，处理其它合并症）。3例缓解，3例死亡。结论ATLS主要发生在恶性度高、生长迅速的肿瘤，与肿瘤负荷巨大有关，以淋巴组织恶性病为最多见。可有自发性ATLS存在。除细胞毒药物外，激素亦可引起ATLS。3／6出现高血糖，超过正常值5～6倍，机制有待研究。ATLS仍是严重的致命的合并症，早期诊断及处理是抢救成功的关键。
Objective To clinically study and analyze 6 cases of acute tumor lysis syndrome (ATLS). The method summarizes the general conditions, clinical and laboratory features and treatment of 6 cases of ATLS from January 1991 to December 1998. Results The myelodysplastic hyperplasia was found in 6 patients with lymphoid malignancy (3 ALL-L2 and 3 NHL) ALL. All NHL patients were in group III-IV B and had large cells. Four patients before chemotherapy had metabolic abnormalities of ATLS. The applied chemotherapy regimen contains hormones other than cytotoxic drugs. After chemotherapy, ATLS appeared in 2 to 7 days. The main manifestations of ATLS are nausea, vomiting, oliguria, palpitation, chest tightness, fatigue, and sweat. Abnormal laboratory tests for ATLS were hyperkalemia (6/6), high urea nitrogen (6/6), metabolic acidosis (6/6), hyperuricemia (3/5), and hyperglycemia (3/6). ), Hypocalcemia (2/2), Hyperphosphatemia (1/2), High blood magnesium 1/2, etc. After active rescue (hydration, alkaline urine, reduce uric acid production, deal with other complications). Three patients eased and three patients died. Conclusion ATLS mainly occurs in malignant tumors with high growth rate, which is related to the huge tumor burden. The most common malignant lymphoid tissue diseases are ATLS. There may be spontaneous ATLS. In addition to cytotoxic drugs, hormones can also cause ATLS. 3/6 hyperglycemia occurs, which is 5-6 times more than normal, and the mechanism remains to be studied. ATLS is still a serious fatal complication. Early diagnosis and treatment are the key to success.