CAJ | 학술논문

目的：探讨采用不同血管通路采集自体外周血造血干细胞的安全性及有效性。方法2012年1月～2014年11月期间行自体外周血造血干细胞采集的87例患者分为两组：外周静脉采集组43例，均采用16G 一次性内瘘针进行穿刺，进血管路选用肘部静脉，返血管路选用大隐静脉。中心静脉采集组44例，均采用双腔股静脉置管建立静脉通路。自体外周血造血的采集均选用 Cobe Spectra 血细胞分离机的 Spectra Auto PBSC 操作程序进行。观察两组患者在穿刺成功率、采集顺利程度、患者术中耐受度、采集过程中的不良反应以及最终采集物中单个核细胞数和 CD34＋细胞计数的差异。结果两组患者采集的自体外周血单个核细胞数及 CD34＋细胞计数间差异无统计学显著性意义（t＝4.159，3.147，P ＞0.05），且均采集达标；采集过程中不良反应在两组患者中差异无统计学显著性意义（χ2＝0.0009，P ＞0.05）；但采用中心静脉组患者穿刺成功率高、采集顺利、患者术中耐受性均高于采用外周静脉通路的患者，差异有统计学意义（χ2＝7.944，13.7729，20.5094，P ＜0.05）。结论采用双腔股静脉置管建立中心静脉通路在自体外周血干细胞采集中具有穿刺成功率高，采集顺利，最大程度减轻了患者的痛苦，且不影响采集效率和效果的优势。
목적：탐토채용불동혈관통로채집자체외주혈조혈간세포적안전성급유효성。방법2012년1월～2014년11월기간행자체외주혈조혈간세포채집적87례환자분위량조：외주정맥채집조43례，균채용16G 일차성내루침진행천자，진혈관로선용주부정맥，반혈관로선용대은정맥。중심정맥채집조44례，균채용쌍강고정맥치관건립정맥통로。자체외주혈조혈적채집균선용 Cobe Spectra 혈세포분리궤적 Spectra Auto PBSC 조작정서진행。관찰량조환자재천자성공솔、채집순리정도、환자술중내수도、채집과정중적불량반응이급최종채집물중단개핵세포수화 CD34＋세포계수적차이。결과량조환자채집적자체외주혈단개핵세포수급 CD34＋세포계수간차이무통계학현저성의의（t＝4.159，3.147，P ＞0.05），차균채집체표；채집과정중불량반응재량조환자중차이무통계학현저성의의（χ2＝0.0009，P ＞0.05）；단채용중심정맥조환자천자성공솔고、채집순리、환자술중내수성균고우채용외주정맥통로적환자，차이유통계학의의（χ2＝7.944，13.7729，20.5094，P ＜0.05）。결론채용쌍강고정맥치관건립중심정맥통로재자체외주혈간세포채집중구유천자성공솔고，채집순리，최대정도감경료환자적통고，차불영향채집효솔화효과적우세。
Objective To assess the safety and efficacy of adopting different vascular access during autologous peripheral blood stem cells collection.Methods 87 patients received autologous peripheral blood stem cells collection were divided into two groups:One was peripheral vein harvesting group (43 cases),which used the 16G disposable fistula needle for autolo-gous peripheral blood stem cell collection and the other central venous harvesting group (44 cases),which used double cavity of femoral vein catheter for autologous peripheral blood stem cell collection.The observation indicators included venous ac-cesses,collection efficiency,patient tolerance,the number of mononuclear cell and CD34 positive cells.Results The numbers of mononuclear cells and CD34 positive cells in two groups were all above the standard and there was no significant differ-ence (P >0.05).However,the success of venous accesses,the efficiency smooth of collection and-patient tolerance were bet-ter in double cavity of femoral vein catheter group (P <0.05).Conclusion Harvesting the autologous peripheral blood stem cell through central venous by using double cavity of femoral vein catheter had the advantages as follows:high success rate of puncture,acquisition smoothly and reducing the suffering extent of the patients,and also it did not affect the acquisition effi-ciency and effectiveness.