摘要
回顾分析我院收治的1例卡介苗(BCG)膀胱内灌注所致间质性肺炎患者的临床资料,以“卡介苗”“膀胱内灌注”“肺炎”“Bacille Calmette-Guérin”“intravesical instillation”“pneumonia”为关键词检索万方、中国知网、维普、PubMed等数据库,复习2014年1月至2024年6月期间所有相关文献。本例患者因膀胱癌行8次BCG膀胱内灌注后出现发热、咳嗽、气急,诊断BCG膀胱内灌注致相关性肺炎,经抗感染、甲泼尼龙抗炎等治疗后症状好转出院。文献复习共20例BCG膀胱内灌注引起肺炎的病例,其中10例为间质性肺炎,10例为粟粒性肺炎。7例间质性肺炎予糖皮质激素联合抗结核治疗,2例联合治疗无效死亡,余病例治疗均有效。粟粒性肺炎的预后较好,其中6例粟粒性肺炎病例仅予抗结核治疗后痊愈。针对严重BCG相关性肺炎,一般予抗结核联合糖皮质激素治疗。
A bladder cancer patient underwent intravesical Bacillus Calmette-Guérin(BCG)instillation in Xiamen Branch,Zhongshan Hospital,Fudan University in April 2023.Following 8 instillations the patient presented with fever,cough and dyspnea,and was diagnosed as interstitial pneumonia(IP).Symptoms resolved after anti-tuberculosis and methylprednisolone treatment,with subsequent successful discharge.Using the keywords′Bacillus Calmette-Guérin,′′intravesical instillation,′′pneumonia,′Wanfang Data,China National Knowledge Infrastructure(CNKI),Weipu(VIP),and PubMed databases were searched for relevant literature published between January 2014 and June 2024,and 20 cases of BCG instillation-induced pneumonia were retrieved,including 10 IP cases and 10 miliary pneumonia cases.Among 10 IP cases,7 received corticosteroids combined with anti-tuberculosis therapy.Two cases unresponsive to combination therapy resulted in mortality,while others showed therapeutic efficacy.Miliary pneumonia demonstrated better prognosis,with 6 cases achieving complete remission through anti-tuberculosis monotherapy.The results indicate that severe BCG-related pneumonia generally necessitates combined anti-tuberculosis and corticosteroid therapy.
作者
陈章燕
刘瑶
雷海燕
郝猛楠
卢聪颖
Chen Zhangyan;Liu Yao;Lei Haiyan;Hao Mengnan;Lu Congying(Department of General Practice,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen 361015,China;Department of General Practice,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《中华全科医师杂志》
2025年第9期1148-1152,共5页
Chinese Journal of General Practitioners
关键词
卡介苗
肺炎
投药
膀胱内
BCG vaccine
Pneumonia
Administration,intravesical
