我如何处理血液移植患者的腹:一个实用的工具
Natalia E Castillo Almeida1, Catherine J Cichon1, Carlos A Gomez1
1Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USA.
概括
血造干细胞移植 (HSCT) 后的腹需要由于各种原因进行仔细的诊断. 多重胃肠 (GI) 聚合酶连锁反应 (PCR) 面板有助于检测病原体,但需要在临床评估中谨慎使用.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 腹是受血造干细胞移植 (HSCT) 患者常见的复杂并发症.
- 原因是多因素的,包括感染,移植与宿主疾病和粘膜炎,使诊断复杂化.
- 既定和新兴的病原体有助于这种脆弱人群的传染性腹.
研究的目的:
- 审查HSCT接受者的传染性腹原因.
- 评估胃肠道 (GI) 多重聚合酶链反应 (PCR) 面板的作用.
- 提出一种用于HSCT相关腹的诊断算法.
主要方法:
- 在HSCT感染性腹的文献综述.
- 对既有和新兴病原体的分析 (例如,细胞巨乳病毒,困难类菌,诺罗病毒,沙波病毒,天体病毒).
- 开发一个综合临床评估,风险分层和分子测试的诊断算法.
主要成果:
- 胃肠道 (GI) 多重PCR面板已经在HSCT腹中改变了病原体检测.
- 区分传染病与非传染病 (粘膜炎,失生症,aGvHD) 的原因仍然具有挑战性.
- 合理应用多重面板对于防止过度测试和确保诊断管理至关重要.
结论:
- 对于HSCT相关的腹,一个多方面的诊断方法是必不可少的.
- 根据临床背景和当地流行病学指导的分子平台的定制利用,优化了患者的护理.
- 将综合测试与诊断管理相平衡,是有效管理的关键.
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