关于提高治疗性白细胞单采手术质量的探讨  

Explore the method to improve the quality of therapeutic leukapheresis

作　　者：葛优[1] 陈诗强[1] 王小超[1] 李天资[1] Ge You;Chen Shiqiang;Wang Xiaochao;Li Tianzi(Department of Blood and Rheumatology,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi　)

机构地区：[1]右江民族医学院附属医院血液风湿科

出　　处：《右江民族医学院学报》2018年第1期58-61,共4页Journal of Youjiang Medical University for Nationalities

基　　金：百色市科技局基金资助项目(百科计20161411)

摘　　要：目的探讨手动干预在治疗性白细胞单采术的临床疗效。方法将50例高白细胞白血病(HLL)的慢性粒细胞白血病(CML)患者随机分为对照组和干预组,每组25例,在化疗前应用血细胞分离机进行白细胞单采治疗,对照组常规用机器自动细胞采集,干预组是手动干预进行白细胞采集,对比两组的疗效。结果对照组与干预组患者术前外周血象各指标比较差异无统计学意义(P>0.05)。对照组术后外周血象白细胞、中性粒细胞、血小板水平与术前比较差异无统计学意义(P>0.05),血红蛋白差异有统计学意义(P<0.001)。干预组术后外周血象白细胞、中性粒细胞、血红蛋白水平与术前比较差异有统计学意义(P<0.001或P<0.05),血小板差异无统计学意义(P>0.05)。治疗后干预组患者白细胞、中性粒细胞、血红蛋白明显低于对照组,差异有统计学意义(P<0.001或P<0.05)。两组凝血功能各项指标及肝肾功能各项指标治疗前后变化不大(P均>0.05)。结论手动干预白细胞单采能快速降低高白细胞白血病的慢性粒细胞白血病患者体内的白细胞数,同时会出现患者血红蛋白明显下降,出现重度贫血(Hb<60g/L)的风险也较高。Objective To explore the clinical effect of manual intervention for the therapeutic leukapheresis. Methods Fifty patients with chronic myelocytic leukemia associated with high white blood cell leukemia were randomly divided into a control group and an intervention group,25 cases in each group.Before chemotherapy,blood cell separator was used for the therapeutic leukapheresis.The white blood cell collection was performed for the control group by using machine conventionally and automatically;and manual intervention for white blood collection by blood cell separator was performed for the intervention group.The curative effect was compared between the two groups. Results Before operation,there were no statistically significant differences between the control group and the intervention group on the indexes of peripheral hemogram(P>0.05).Compared the preoperative indexes with the postoperative indexes in the control group,there were no significant differences on the peripheral hemogram leukocyte count,the neutrophil count and the blood platelet(P>0.05),while there was significant difference on hemoglobin(P<0.001).Compared the preoperative indexes with the postoperative indexes in the intervention group,there were significant differences on peripheral hemogram leukocyte count,neutrophil count and hemoglobin values(P<0.001 or P<0.05),while there was no significant difference on blood platelet count(P>0.05).After treatment,the intervention group patients had lower leukocyte count,neutrophile granulocyte count and hemoglobin values than the control group,comparing between the two groups yielded statistically significant differences(P<0.001 or P<0.05).The coagulation function indexes,liver and kidney function indexes in both of the two groups changed little before and after operation(all P>0.05). Conclusion Manual intervention for leukapheresis can reduce quickly the leukocyte count in patients with chronic myelocytic leukemia associated with high white blood cell leukemia,meanwhile the hemoglobin of patients will decrease

关 键 词：慢性粒细胞白血病 手动干预 白细胞去除术 

分 类 号：R331.123[医药卫生—人体生理学]