【摘要】 目的 总结化疗药物致外周血中性粒细胞缺乏症患者的临床综合治疗并观察脐血输注在防止化疗后骨髓抑制,加速骨髓损伤恢复方面的作用。方法 22例不同实体瘤患者因使用含NVB、DDP、IFO的方案化疗,致外周血中性粒细胞减少最终低于0.5×10~9/L时的综合救治;60例实体瘤患者应用含DDP、紫素、ADM的方案化疗,随机分为二组,采用自身交叉对比的方法,观察预防性使用脐血输注后血象的变化。结果 22例粒细胞缺乏症的患者化疗后白细胞总数及粒细胞绝对值降至最低值的时间为12.24±2.08天,其中粒细胞绝对值低于0.1×10~9/L者5例,低于0.5×10~9/L者17例,经采用rhG-CSF、脐血及预防性使用抗菌素、严格的隔离消毒制度等措施,没有一例发生感染,ANC最低值<0.5×10~9/L,持续4.31±1.97天后恢复至大于1.5×10~9/L,WBC最低值持续9.47±5.10天后恢复至大于4×10~9/L;预防性使用脐血输注使骨髓抑制的程度减少,恢复至正常的时间缩短。结论 在粒细胞缺乏症的临床救治中,严格的隔离措施及应用rhG-CSF、脐血及抗菌素等综合措施是治疗成功的关键;脐血输注能加速骨髓造血功能恢复,帮助患者顺利渡过骨髓抑制的危险期,减少并发症,改善生活质量,使患者能如期化疗,提高生存率。更多还原

【Abstract】 [Abstract] Objective Observe the action of cord blood in therapy of agranulocytosis induced by chemotherapy .Methods The combination therapy of 22 cases whose ANC decrease to below 0.5× 10 9 / L; 60 patients with cancer received cord blood infusion followed by one cycle of the same regimen as control. The changes of absolute neutrophil count during chemotherapy course between cycles were com pared. Results 22 cases with agranulocytosis decreased to the lowest level on the 12.24 2.08th day after chemotherapy .ANC in 5 cases were lower than 0.1×10 9/ L , that in the others were lower than 0.5 × 10 9/L . After using of the rhG-CSF, cord blood, rigorously sterilizing measures and vigorous antibiotic treatment, all of the patients could successfully pass through the bone marrow depression phase without infection; in the other group, the patients were treated by cord blood infusion immediately after chemotherapy, the bone marrow depression in this group was lighten than that of control, and the recovery time was shorter. Conclusions To combine using rhG-CSF, cord blood infusion, rigorously sterilizing measures and vigorous antibiotic play a key role in treatment of granulocytosis; using cord blood infusion is one of most important methods in the recovery of hematopoietic function.更多还原