采用不同血管通路采集自体外周血造血干细胞的安全性及有效性评估  

Safety and Efficacy of Adopting Different Vascular Access During Autologous Peripheral Blood Stem Cells Collection

作　　者：陈瑾[1] 郭彩利[1] 孙春红[1] 刘芳[1] 王艳[1] 王晓宁[1] 

机构地区：[1]西安交通大学第一附属医院,西安710061

出　　处：《现代检验医学杂志》2015年第4期111-114,共4页Journal of Modern Laboratory Medicine

摘　　要：目的：探讨采用不同血管通路采集自体外周血造血干细胞的安全性及有效性。方法2012年1月～2014年11月期间行自体外周血造血干细胞采集的87例患者分为两组：外周静脉采集组43例，均采用16G 一次性内瘘针进行穿刺，进血管路选用肘部静脉，返血管路选用大隐静脉。中心静脉采集组44例，均采用双腔股静脉置管建立静脉通路。自体外周血造血的采集均选用 Cobe Spectra 血细胞分离机的 Spectra Auto PBSC 操作程序进行。观察两组患者在穿刺成功率、采集顺利程度、患者术中耐受度、采集过程中的不良反应以及最终采集物中单个核细胞数和 CD34＋细胞计数的差异。结果两组患者采集的自体外周血单个核细胞数及 CD34＋细胞计数间差异无统计学显著性意义（t＝4.159，3.147，P ＞0.05），且均采集达标；采集过程中不良反应在两组患者中差异无统计学显著性意义（χ2＝0.0009，P ＞0.05）；但采用中心静脉组患者穿刺成功率高、采集顺利、患者术中耐受性均高于采用外周静脉通路的患者，差异有统计学意义（χ2＝7.944，13.7729，20.5094，P ＜0.05）。结论采用双腔股静脉置管建立中心静脉通路在自体外周血干细胞采集中具有穿刺成功率高，采集顺利，最大程度减轻了患者的痛苦，且不影响采集效率和效果的优势。Objective To assess the safety and efficacy of adopting different vascular access during autologous peripheral blood stem cells collection.Methods 87 patients received autologous peripheral blood stem cells collection were divided into two groups：One was peripheral vein harvesting group （43 cases）,which used the 16G disposable fistula needle for autolo-gous peripheral blood stem cell collection and the other central venous harvesting group （44 cases）,which used double cavity of femoral vein catheter for autologous peripheral blood stem cell collection.The observation indicators included venous ac-cesses,collection efficiency,patient tolerance,the number of mononuclear cell and CD34 positive cells.Results The numbers of mononuclear cells and CD34 positive cells in two groups were all above the standard and there was no significant differ-ence （P 〉0.05）.However,the success of venous accesses,the efficiency smooth of collection and-patient tolerance were bet-ter in double cavity of femoral vein catheter group （P 〈0.05）.Conclusion Harvesting the autologous peripheral blood stem cell through central venous by using double cavity of femoral vein catheter had the advantages as follows：high success rate of puncture,acquisition smoothly and reducing the suffering extent of the patients,and also it did not affect the acquisition effi-ciency and effectiveness.

关 键 词：造血干细胞采集 双腔股静脉置管 单个核细胞 

分 类 号：R457[医药卫生—治疗学]