CAJ | 학술논문

目的初步探讨血液成分单采术在血液病治疗中的应用并观察其不良反应.方法对524例患者应用CS-3000 plus血细胞分离机进行916次治疗性血液成分单采,根据病人情况选择不同细胞收集程序,分析临床效果和实验室指标的改善情况,并分析其不良反应及处理措施.结果行血细胞单采术后210例高白细胞患者白细胞由(230.1±48.5)×109/L降至(49.3±10.0)×109/L;123例真性红细胞患者血红蛋向由(216.0±23.0)g/L降至(150.0±12.0)g/L,红细胞由(7.1±0.5)×1012/L降至(4.3±O.8)×1012/L;158例高血小板患者血小板由(1 080.0±314.0)×109/L降至(341.0±82.0)×109/L,治疗前后差异均有统计学意义(P<0.01).32例血栓性血小板减少性紫癜患者行血浆置换后,90.6%患者临床症状、体征及实验室指标均明显改善.少部分患者出现枸橼酸盐中毒(3.0%)、低血容量休克(0.7%)、过敏反应(4.6%)等不良反应,经对症处理后均得以缓解.结论利用血细胞分离机进行治疗性血液成分单采术和血浆置换术可迅速缓解临床症状,减少并发症的发生,疗效肯定且安全可靠,不良反应少,并对提高临床药物治疗效果有很大意义.
목적 초보탐토혈액성분단채술재혈액병치료중적응용병관찰기불량반응.방법 대524례환자응용CS-3000 plus혈세포분리궤진행916차치료성혈액성분단채,근거병인정황선택불동세포수집정서,분석림상효과화실험실지표적개선정황,병분석기불량반응급처리조시.결과 행혈세포단채술후210례고백세포환자백세포유(230.1±48.5)×109/L강지(49.3±10.0)×109/L;123례진성홍세포환자혈홍단향유(216.0±23.0)g/L강지(150.0±12.0)g/L,홍세포유(7.1±0.5)×1012/L강지(4.3±O.8)×1012/L;158례고혈소판환자혈소판유(1 080.0±314.0)×109/L강지(341.0±82.0)×109/L,치료전후차이균유통계학의의(P<0.01).32례혈전성혈소판감소성자전환자행혈장치환후,90.6%환자림상증상、체정급실험실지표균명현개선.소부분환자출현구연산염중독(3.0%)、저혈용량휴극(0.7%)、과민반응(4.6%)등불량반응,경대증처리후균득이완해.결론 이용혈세포분리궤진행치료성혈액성분단채술화혈장치환술가신속완해림상증상,감소병발증적발생,료효긍정차안전가고,불량반응소,병대제고림상약물치료효과유흔대의의.
Objective To investigate the clinical effect of therapeutic hemapheresis and observe the adverse reaction. Methods CS-3000 plus blood cell separator was used for therapeutic hemapheresis in 524 patients. We selected the different cell collection procedures according to the patients' conditions and analyzed the clinical effects, the laboratory indexes, the adverse reactions and corresponding handlings. Results After therapeutic hemapheresis, the leucocyte counts was decreased from (230. 1±48. 5) × 109/L to (49. 3±10. 0) × 109/L in 210 patients with high white blood cell, the hemoglobin was decreased from (216.0±23.0) g/L to (150. 0 ± 12. 0) g/L and the erythrocyte counts was decreased from (7.1±0.5)× 1012/L to (4. 3±0. 8) X 10 12/L in 123 patients with polycythemia vera, the platelet counts was decreased from (1 080. 0±314. 0)×109/L to (341. 0 ± 82. 0) × 109/L in 158 patients with high platelet. There were significant differences (P < 0. 01) before and after treatment. The significant improvement of clinical symptoms and laboratory indexes were gained in 90. 6% patients with TTP after therapeutic plasmatic exchange by CS-3000 plus blood cell separator. There were a few incidences of citrus salt poisoning (3. 0%), hypovoletnic shock (0. 7%) and allergic reactions (4. 6%) as adverse reaction, but the complications were relieved after corresponding treatment. Conclusion Therapeutic hemapheresis is significant for rapidly improving clinical symptoms, reducing occurrence of complications and enhancing the curative effect of drugs.