以血小板异常增高为表现的慢性粒细胞白血病合并脑出血患者成功救治一例  

Successful Treatment of A Patient with Chronic Myeloid Leukemia Complicated by Cerebral Hemorrhage Manifesting as Platelet Abnormal Elevation

作　　者：张鑫[1] 张笑[1] 郭毅[1] 冯俊[2] 肖志源 解兆祥 武静[1] 许冬蕊 魏俊吉[1] 王裕[1] ZHANG Xin;ZHANG Xiao;GUO Yi;FENG Jun;XIAO Zhiyuan;XIE Zhaoxiang;WU Jing;XU Dongrui;WEI Junji;WANG Yu(Department of Neurosurgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Hematology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院神经外科,北京100730 [2]中国医学科学院北京协和医院血液内科,北京100730

出　　处：《协和医学杂志》2024年第1期217-222,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：中央高水平医院临床科研专项(2022-PUMCH-032);京津冀基础研究合作专项[19JCZDJC64600(Z)]。

摘　　要：血小板升高为慢性粒细胞白血病(chronic myeloid leukemia,CML)患者外周血的罕见表现。本文首次报道1例以血小板异常增高为表现的CML合并脑出血病例。该患者外周血血小板升高,凝血功能正常,因脑出血行颅内血肿清除术,术后出现术区和其他系统出血,结合骨髓活检及基因检测确诊为CML。予以氟马替尼经空肠管给药后,患者病情得以控制,此项治疗尚属国内外首次报道。本文对该患者的诊治过程进行梳理,以期为临床医师提供警示与借鉴。Platelet elevation is a rare manifestation in the peripheral blood of patients with chronic myeloid leukemia(CML).In this paper,we report for the first time a case of CML combined with cerebral hemorrhage manifested by abnormally elevated platelets.The patient had elevated platelets in the peripheral blood,showed normal coagulation function,and underwent intracranial hematoma removal due to cerebral hemorrhage.After the operation,bleeding from the operated area and other systems occurred,and the patient was diagnosed as having accelerated CML after combining bone marrow biopsy and genetic testing.His condition was controlled after administration of flumatinib through a jejunal tube.Based on this patient's experience,the feasibility of administering flumatinib via a jejunostomy tube was determined,which is the first report of its kind in China and abroad.This article summarizes the diagnosis and treatment process of this patient,with the aim of providing a warning and reference for clinicians.

关 键 词：脑出血 血小板增高 慢性粒细胞白血病 

分 类 号：R651.19[医药卫生—外科学] R557[医药卫生—临床医学]