CAJ | 학술논문

背景:晚期肝病及肝移植后造血系统受累相关报道较少见.目的:通过对肝移植患者围手术期骨髓细胞学的观察,探讨移植前造血功能的改变及移植后多种并发症对骨髓造血功能的影响.方法:选择20例实施原位肝移植患者,因与血液系统疾病相关,需行骨髓细胞学检查进行诊断及鉴别诊断,其中移植前2例,移植后18例.结果与结论:原位肝移植患者移植前容易出现骨髓细胞学改变为脾功能亢进、大红细胞性贫血,移植后出现:移植物抗宿主病、浆细胞白血病、反应性粒细胞增高、原发性血小板减少性紫癜、嗜血细胞综合征、粒细胞缺乏症、急性造血细胞停滞、转移癌、反应性血小板增高.说明通过骨髓细胞学检查,监测肝移植围手术期各种并发症对骨髓造血功的影响,特别对移植物抗宿主病的患者,实施及时抢救有重要意义.
배경:만기간병급간이식후조혈계통수루상관보도교소견.목적:통과대간이식환자위수술기골수세포학적관찰,탐토이식전조혈공능적개변급이식후다충병발증대골수조혈공능적영향.방법:선택20례실시원위간이식환자,인여혈액계통질병상관,수행골수세포학검사진행진단급감별진단,기중이식전2례,이식후18례.결과여결론:원위간이식환자이식전용역출현골수세포학개변위비공능항진、대홍세포성빈혈,이식후출현:이식물항숙주병、장세포백혈병、반응성립세포증고、원발성혈소판감소성자전、기혈세포종합정、립세포결핍증、급성조혈세포정체、전이암、반응성혈소판증고.설명통과골수세포학검사,감측간이식위수술기각충병발증대골수조혈공적영향,특별대이식물항숙주병적환자,실시급시창구유중요의의.
BACKGROUND: The reports on the advanced liver disease and liver transplantation hematopoietic system which affected are rare. OBJECTIVE: To study the characteristics of hematopoiesis function before orthotopic liver transplantation and the effects of a series of post-operation complications on hematopoiesis function of the bone marrow after orthotopic liver transplantation by observing bone marrow cytology. METHODS: Bone marrow cytology was analyzed in 20 cases of orthotopic liver transplantation. Due to the relationship with hematological diseases, bone marrow cytology examination was needed to be performed to diagnosis and differential diagnosis. Two cases received the examination before transplantation and 18 cases received the examination after transplantation. RESULTS AND CONCLUSION: Hypersplenism and macrocytic anemia could be seen in the patients with orthotopic liver transplantation before transplantation. Graft versus host disease, plasma cel leukemia, leukemoid reaction, idiopathic thrombocytopenic purpura, hemophagocytic syndrome, metastatic hepatic carcinoma, agranulocytosis, acute hematopoietic cel s stagnation and reactive thrombocytosis were shown after transplantation. Monitoring the effect of various complications in the perioperative period of liver transplantation on bone marrow hematopoietic function through bone marrow cytology examination has important significance for the treatment of patients with graft versus host disease.