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目的 :通过序贯性综合治疗儿童急性淋巴细胞白血病 2 6例临床分析 ,总结经验教训 ,提高对儿童白血病的诊治水平。方法 :儿童急性淋巴细胞白血病在诱导治疗期间 ,采用VDLP、CODP、VMP及COAP等方案 ,如为难治性白血病加用米托蒽醌、足叶乙甙等药物 ;在巩固治疗期采用CAM、VAE等方案化疗 ;髓外白血病的预防采用二联或三联鞘注。结果 :2 6例中有 2 5例在诱导治疗后达完全缓解 (CR) ,CR率 96 1% ;在治疗过程中出现明显骨髓抑制达 42例次 ;血小板减少伴有明显出血倾向 10例次 ;肝功能损害 5例次 ;脱发 6例次 ;口腔溃疡及粘膜重度损害 6例次 ;合并肺炎伴心衰 1例 ;药物性皮疹 1例 ;脊神经损伤 1例 ,经过综合治疗 ,除 1例死亡 ,余者顺利达到治疗目的。结论 :序贯性综合治疗儿童急性淋巴细胞白血病是行之有效的治疗方法 ,只要医生在患儿治疗过程中做到准确的诊断 ,周密的治疗措施的设计 ,耐心的观察患儿的病情变化 ,心中有数 ,有的放矢 ,都可以收到预期的效果
Objective: Through the sequential comprehensive treatment of children with acute lymphoblastic leukemia clinical analysis of 26 cases, to sum up experiences and lessons learned to improve the diagnosis and treatment of childhood leukemia. Methods: Children with acute lymphoblastic leukemia during the induction therapy, the use of VDLP, CODP, VMP and COAP and other programs, such as refractory leukemia with mitoxantrone, etoposide and other drugs; in the consolidation period using CAM, VAE Chemotherapy and other programs; prevention of extramedullary leukemia or triple triple intrathecal injection. RESULTS: Twenty-five of 26 patients achieved complete remission (CR) after induction therapy, with a CR rate of 96.1%. Significant bone marrow suppression occurred in 42 patients during treatment, and thrombocytopenia was associated with significant bleeding ten times ; Liver function damage in 5 cases; alopecia in 6 cases; oral ulcer and mucosal injury in 6 cases; pneumonia with heart failure in 1 case; drug-induced rash in 1 case; spinal nerve injury in 1 case, after comprehensive treatment, except 1 case of death , The other successfully reached the goal of treatment. Conclusion: Sequential comprehensive treatment of children with acute lymphoblastic leukemia is an effective treatment method, as long as the doctor in the treatment of children to do accurate diagnosis, careful treatment design, patience to observe changes in children’s condition, There are numerous, targeted, can receive the desired results