同步骨髓活检与涂片检查在血液病诊断与治疗中的作用  

Evaluation of bone marrow biopsy and smear examinations in diagnosis and treatment for patients with hematologic disease by simultaneously comparative study

作　　者：林金盈[1] 任咏薇[1] 李永敢[1] 曾维平[1] 闭艺芳[1] 冯敏[1] 

机构地区：[1]广西壮族自治区人民医院血液内科,南宁530021

出　　处：《广西医学》2005年第9期1324-1327,共4页Guangxi Medical Journal

基　　金：广西壮族自治区卫生厅医药卫生科研课题(桂卫Z9954)

摘　　要：目的了解骨髓涂片及活检在血液病鉴别诊断中的地位及其对疗效判断的价值。方法对我院住院的急性白血病患者和全血细胞减少症病人同步进行骨髓活检与涂片检查,骨髓活检标本经处理后,塑料包埋,切成3μm切片,HGF染色。骨髓涂片经瑞氏染色后常规检查。结果骨髓活检增生度高于涂片;误诊率(4.76%)低于涂片(35.71%);9例治疗好转的再生障碍性贫血(AA),其骨髓活检恢复正常的时间平均比涂片正常时间早约4周;而白血病的病人骨髓涂片提示缓解的时间要早于活检,多数第一次缓解的病人骨髓活检中仍可见到成堆或小片状分布的幼稚细胞。结论骨髓涂片及活检对于血液病的诊断与疗效的观察有互补作用,不能相互取代。对于化疗后及全血细胞减少的病人,应常规同步做骨髓的涂片及活检检查。Objectives To simultaneously compare and evaluate the examinations of bone marrow smear and trephine biopsy in differential diagnosis and the therapeutical effect of patients with hematologic disease. Methods We study simultaneously bone marrow smear and trephine biopsy in 71 patients with pancytopenia and 34 patients with acute leukemia. BM smears are stained with Wright stain. BM biopsy material is processed and embedded in plastic,and sections（3 ,tan） are made for examination. The sections are stained with HGF. Results The results showed that the degree of cellularity in bone marrow biopsy for cytologic morphology was higher than that for smear, but the misdiagnosis rate was lower than that in the smear. Conclusion Bone marrow aspiration and trephine biopsy are complementary techniques for diagnosis and evaluation of the therapeutical effect of patients with hematologic disease, especially of the patients with pancytopenia and acute leukemia after chemotherapy.

关 键 词：活检 涂片 骨髓 全血细胞减少症 白血病 

分 类 号：R446[医药卫生—诊断学]