初诊恶性血液病合并危重新型冠状病毒肺炎诊治伴文献复习  

Diagnosis and treatment of newly diagnosed hematological malignancies with critical COVID-19 and literature review

作　　者：李倩[1] 谢妍 梁佩淇 刘子溢 李渭阳[1] 王栋 高梦 李冰清 吴德沛[1] 陆茵[1] 付建红[1] LI Qian;XIE Yan;LIANG Peiqi;LIU Ziyi;LI Weiyang;WANG Dong;GAO Meng;LI Bingqing;WU Depei;LU Yin;FU Jianhong(National Clinical Research Center for Hematologic Diseases,Hematological Intensive Care Unit,Department of Hematology,the First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,Suzhou,Jiangsu,215006,China)

机构地区：[1]国家血液系统疾病临床医学研究中心,苏州大学附属第一医院血液科重症监护病房,江苏省血液研究所,江苏苏州215006

出　　处：《临床血液学杂志》2025年第1期20-24,共5页Journal of Clinical Hematology

基　　金：白求恩公益基金会课题(No:2022-YJ-085-J-Z-ZZ-022);苏州大学横向研究课题(No:H211284)。

摘　　要：目的:分析在2022年12月我国疫情防控政策调整后,奥密克戎传播高峰时期初诊恶性血液病(HM)合并危重新型冠状病毒肺炎患者的诊治。方法:回顾性分析苏州大学附属第一医院血液重症监护病房(HCU)收治的8例初诊HM合并危重新型冠状病毒肺炎的临床表现、治疗及预后,结合既往文献总结此类患者的救治经验。结果:8例患者均因呼吸衰竭接受了机械通气,其中4例为有创通气,3例患者接受升压药治疗,3例接受连续性肾脏替代治疗,7例接受诱导化疗,经血液专科治疗结合ICU生命支持后院内生存率为62.5%。结论:初诊HM患者免疫功能低下,在大流行的背景下感染后易进展为重型/危重型新型冠状病毒肺炎,血液专科ICU能充分结合血液专科治疗和高级生命支持提高患者救治成功率。Objective:To analyze the diagnosis and treatment of newly diagnosed patients with hematological malignancies(HMs)and critical COVID-19 during the peak of Omicron transmission after the adjustment of China's epidemic prevention and control policy in December 2022.Methods:A retrospective analysis was conducted on the clinical manifestations,treatment,and prognosis of 8 patients with newly diagnosed HM suffering from critical COVID-19 admitted to the Hematology ICU of the First Affiliated Hospital of Soochow University.The rescue experience for such patients was summarized in combination with previous literature.Results:All 8 patients underwent mechanical ventilation due to respiratory failure,including 4 cases of invasive mechanical ventilation.Three patients received vasopressors,3 underwent continuous renal replacement therapy(CRRT),and 7 received induction chemotherapy.The in-hospital survival rate after treatment of HMs combined with ICU life support was 62.5%.Conclusion:Patients with newly diagnosed HM have decreased immune function and are prone to progressing to severe/critical COVID-19 upon infection against the backdrop of the pandemic.The Hematology ICU can effectively improve the survival of this population by fully integrating hematological treatment and advanced lifesupport.

关 键 词：恶性血液病 新型冠状病毒肺炎 奥密克戎 重症监护病房 

分 类 号：R55[医药卫生—血液循环系统疾病]