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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。
Objective To summarize the clinical effects of chemotherapeutic drugs on peripheral blood neutrophilic granulomatosis patients and to observe the role of cord blood transfusion in preventing bone marrow suppression after chemotherapy and accelerating the recovery of bone marrow injury. Methods Twenty-two patients with solid tumors underwent chemotherapy with NVB, DDP, and IFO, resulting in a total reduction of peripheral blood neutropenia of less than 0.5 × 10 ~ 9 / L. Sixty solid tumor patients with DDP , Zijin, ADM chemotherapy, were randomly divided into two groups, using their own cross-contrast method to observe the changes in blood after prophylactic use of cord blood transfusion. Results The total number of leukocytes and the absolute value of neutrophils after chemotherapy in 22 patients with agranulocytosis were 12.24 ± 2.08 days. The absolute value of neutrophils was lower than 0.1 × 10 ~ 9 / L in 5 patients, which was lower than 0.5 × 10 ~ 9 / L in 17 cases, by using rhG-CSF, cord blood and prophylactic use of antibiotics, strict isolation and disinfection system and other measures, no case of infection, the lowest ANC <0.5 × 10 ~ 9 / L, Continued to 4.31 ± 1.97 days after recovery to greater than 1.5 × 10 ~ 9 / L, the lowest WBC continued to 9.47 ± 5.10 days to recover to greater than 4 × 10 ~ 9 / L; prophylactic use of cord blood infusion to reduce bone marrow suppression, recovery Shorten to normal time. Conclusion In the clinical treatment of agranulocytosis, strict isolation and application of rhG-CSF, umbilical cord blood and antibiotics and other comprehensive measures is the key to the success of treatment; cord blood transfusion can accelerate the recovery of bone marrow hematopoietic function, to help patients get through The danger of bone marrow suppression, reduce complications and improve the quality of life, so that patients can be scheduled chemotherapy, improve survival.