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目的探讨骨髓血干细胞采集及肝内移植过程中故障的应对。方法对20例患者于髂骨上棘穿刺采集自体骨髓,采用过滤、沉淀等方法获得含干细胞的骨髓血,经与门静脉插管相连的皮下药盒注入,对出现故障的进行观察和分析。结果每例采集和注入3次,共60人次,出现故障6人次(10%),其中导管堵塞最多见(3人次);皮下药盒与门静脉插管连接头滑脱1人次;骨髓穿刺困难,抽取量少1人次;皮下脂肪层过厚,穿刺困难1人次。经及时处理后,60人次均顺利完成骨髓血的采集和移植。结论骨髓血采集及经皮下药盒肝内移植过程中可能出现困难,以导管堵塞最多见,处理不当,移植难以顺利进行。为确保移植成功,必需预防为主,做好移植前准备和移植后处理。出现困难时,应及时应变,妥善处理。
Objective To investigate the response of bone marrow stem cells in blood collection and intrahepatic transplantation. Methods Twenty patients with autologous bone marrow were collected from the superior iliac spine. The bone marrow cells containing stem cells were obtained by filtration and sedimentation. The subcutaneous injection cartridges connected with portal vein cannulation were used to observe and analyze the failure. Results Six cases (10%) were collected and injected in each case for 60 times, with the most common occlusion of the catheter (3 times); the subcutaneous kit and the portal vein were slipping off 1 times; Less 1 person; subcutaneous fat layer is too thick, puncture difficulties 1 person. After timely processing, 60 people successfully completed the bone marrow blood collection and transplantation. Conclusion Bone marrow blood collection and transcutaneous subcutaneous drug delivery may be difficult in the process of intrahepatic transplantation, the most common catheter blockage, improper handling, transplantation difficult to proceed smoothly. In order to ensure the success of transplantation, prevention must be the main pre-transplant preparation and post-transplant processing. When difficulties arise, they should be promptly dealt with and properly dealt with.