强烈化疗后Ⅳ度骨髓抑制的治疗研究  

Treatment for the patients with gradeⅣmyelosuppression after intensive chemotherapy

作　　者：吴世凯[1] 张伟京[1] 俞受程[1] 高艳秋[1] 刁艳青 林育松[1] 李金英[1] 

机构地区：[1]军事医学科学院附属医院淋巴瘤科,北京100039

出　　处：《中国肿瘤临床与康复》2000年第2期28-29,共2页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　研究探讨强烈化疗后Ⅳ度骨髓抑制患者的救治方法。方法　化疗后当绝对粒细胞计数 (ANC)≤ 0 .5× 10 9/L时 ,对患者采取保护性隔离 ,应用粒细胞刺激因子 (G CSF)、抗菌素等直至血象恢复至ANC≥ 2 .0× 10 9/L。当出现感染性发热时抗菌素应用至感染控制。结果　共救治 72例患者 ,ANC≤ 0 .5× 10 9/L的中位持续天数为 3天 ,保护性隔离的中位天数为 6天。抗菌素应用的中位天数为 6天 ,G CSF应用的中位天数为 5天。 7例接受了血小板输注。 2 8例出现感染性发热 ,1例死于感染性休克。结论　对于强烈化疗后Ⅳ度骨髓抑制患者 ,及时采取保护性隔离 ,应用G CSF、抗菌素、输注血小板等综合处理 ,患者可安全、快速渡过危险阶段。? Objective To study how to rescue the patients with grade Ⅳ myelosuppression after intensive chemotherapy.Methods When absolute neutrophil count(ANC) fell below 0.5×10 9/L,the patients were isolated in a laminar airflow unit or strictly sterilized room,and were given granulocyte colony stimulating factor(G CSF) and antibiotic until white ANC rose over 2.0×10 9/L.Once infectious fever occured,antibiotic therapy should last till infection was well controlled.Results Of 72 patients with grade Ⅳ myelosuppression,The median time for ANC lasting below 0.5×10 9/L was 3 days,and the median time for patients in isolation room was 6 days,the median antibiotic therapy time was 6 days,the median time using G CSF was 5 days,7 patients received platelet infusion.Infectious fever occurred in 28 patients,only one patient died.Conclusions If combined treatment is given properly,the patient with grade Ⅳ myelosuppression may safely survive over dangerous period. 〔

关 键 词：化疗 骨髓抑制 粒细胞刺激因子 抗菌素 

分 类 号：R730.53[医药卫生—肿瘤]