自体骨髓干细胞移植治疗早期股骨头缺血性坏死的安全性与有效性

目的评价分析自体骨髓干细胞移植治疗早期股骨头缺血性坏死过程中,自体骨髓血红细胞回输的安全性与有效性。方法对2005年5月～2010年12月间自体干细胞移植治疗早期股骨头缺血性坏死的85名患者进行分析。自双侧髂前上棘单点多层面、多方向采集骨髓血,应用Cobe Spectra 6.1骨髓处理程序分离单个核细胞悬液后,将留下的骨髓血经去浆、盐水洗涤后回输。同时单个核细胞悬液分次加压注入需治疗的患者股骨头内。分析骨髓血经细胞分离后的变化,比较自体骨髓干细胞移植术前后患者Hb变化。结果患者采集骨髓血量为(420±5)ml,细胞悬液股骨头内回注无异常反应;骨髓血洗涤回输过程均未出现输血反应;无任何部位感染。回输血液样品细菌培养均未见细菌生长。单个核细胞悬液采集量平均为(50±16)ml,洗涤红细胞回输量为(360±35)ml。移植手术前后患者Hb平均浓度分别为(13.5±2.2)g/L和(12.8±1.8)g/L,配对t检验结果为0.348 3,P0.05;采集骨髓血Hb总量及Hct与洗涤后回输血比较均无统计学意义(P0.05)。结论利用Cobe Spectra 6.1骨髓处理程序分离骨髓血中单个核细胞后去浆洗涤骨髓血回输安全,Hb损失率小,有利于患者细胞移植后的早期恢复,最大限度减少了患者血液丢失。

The safety and effectiveness of BMSC transplantation in avascular necrosis of femeral head in early stage

Objective To investigate safety and effectiveness of marrow blood in the process of collection and re-transfusion about bone marrow stem cells transplantation.Methods From May 2005 to December 2010,85 cases of avascular necrosis of femeral head in early stage were treated by bone marrow stem cells transplantation.Patients age ranges from 22~56 years old,average age was(38±8.9)years old.Marrow blood was collected by bilateral anterior superior iliac crest using acupuncture needle with lateral holes,The total volume was(420±5)ml.Bone marrow process of Cobe Spectra 6.1 can guarantee the quality of cell fluid.After nucleated cell fluid gathered,the marrow blood was washed by saline and transfused to patients in order to decrees blood loss according to blood transfusion standard of nation.The sample of washed blood was cultivated and blood analysis was done.Results The processes of cell transplantation were completed without blood damage and coagulation.No bacteria positive result and severe complication occurred.The volume of aspiration and re-transfusion was(420±5)ml and(360±35)ml,respectively.Concentrated cell fluid was(50±16)ml;Average hemoglobin concentration before and after transplantation of patients was(13.5±2.2)g/L and(12.8±1.8)g/L,paired t test result was 0.348 3,P>0.05;there was no statistical difference in hemoglobin and MCV between gathered marrow blood and washed red blood cells,P>0.05.Conclusion Our process of cell transplantation is smooth and no severe complications.The loss rate of RBC is low.It is benefit to early recovery of patients after cell transplantation.Blood loss is prevented effectively.