输注浓缩粒细胞抢救药物性粒细胞减少症

输注浓缩粒细胞抢救药物性粒细胞减少症１００８５３北京解放军总医院李锡金，刘景汉关键词粒细胞缺乏症；治疗学中国图书资料分类号Ｒ４６７．１服用某些退热药物，如阿斯匹林和朴热息痛等所致的急性粒细胞缺乏日渐增多。多数病人发病急，来势凶猛，若不及时抢救可危及生...     

儿童粒细胞减少症147例临床分析

粒细胞减少症是指由于血循环中性粒细胞绝对值减少低于正常而出现的一组疾病。其病因较多,感染所致的粒细胞减少症最为常见,但目前常见的抗生素、解热镇痛药物的滥用亦有可能为此类疾病明显高发的原因之一。本研究对近年我科收治的147例粒细胞减少症患儿进行研究总结,提高对其病因的认识,从而指导治疗。1对象与方法     

Observation on the Efficacy of Reduning Injection in the Treatment of Chickenpox and Neutropenia

目的:探讨热毒宁治疗水痘并中性粒细胞减少症的疗效.方法:将2009-11～2012-01本院儿科收治的64例水痘合并中性粒细胞减少症患儿分成两组,治疗组32例给予热毒宁注射液静脉滴注,对照组32例给予阿昔洛韦静脉滴注,疗程5～7 d,同时根据病情给予抗炎,对症,支持治疗.对两组病例皮疹消退时间,热退时间,中性粒细胞恢复正常时间作综合比较.结果:治疗组总有效率为 96.8%,对照组为 75%.两组比较差异有统计学意义(P＜0.01 ).结论:热毒宁注射液治疗水痘合并中性粒细胞减少症疗效较好,值得临床推广应用.     

热毒宁注射液治疗水痘并中性粒细胞减少症32例疗效观察

目的：探讨热毒宁治疗水痘并中性粒细胞减少症的疗效.方法：将2009-11～2012-01本院儿科收治的64例水痘合并中性粒细胞减少症患儿分成两组,治疗组32例给予热毒宁注射液静脉滴注,对照组32例给予阿昔洛韦静脉滴注,疗程5～7 d,同时根据病情给予抗炎,对症,支持治疗.对两组病例皮疹消退时间,热退时间,中性粒细胞恢复正常时间作综合比较.结果：治疗组总有效率为 96.8%,对照组为 75%.两组比较差异有统计学意义（P＜0.01 ）.结论：热毒宁注射液治疗水痘合并中性粒细胞减少症疗效较好,值得临床推广应用.     

聚乙二醇化重组人粒细胞刺激因子注射液过敏反应1例

近年来,对于高粒细胞减少症(febrile neutropenia,FN)风险的患者,常规使用聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF).该药对于减少白细胞降低及中性粒细胞减少性发热起到积极预防作用,常见不良反应为骨痛、关节痛及肌肉酸痛等,国内严重过敏反应的相关报道罕见.我科1例乳腺癌患者,术后行吡柔比星联合环磷酰胺化疗48 h后皮下注射PEG-rhG-CSF出现过敏反应,表现为胸闷、呼吸困难、腹痛等,现报告如下.     

中药三仙三胶汤治疗白细胞减少症临床观察

白细胞减少症（主要是中性粒细胞减少及粒细胞缺乏），西药升白药（以后简称西药）如鲨肝醇、利血升、维生素B4、升白胺等，临床应用多年无肯定疗效。我们根据中药三仙三胶汤（以后简称中药）应用于白血病化疗后骨髓受抑病人明显缩短了骨髓恢复时间这一成形经验[1]，二年来我们试用于白细胞减少症的治疗，收到良好效果。现报导如下。1材料和方法1．1病例选择12例均符合张之南主编血液病诊断及疗效标准中的粒细胞减少症及粒细胞缺乏症[2]其中粒细胞减少症9例，粒细胞缺乏症3例。下例疾病不在观察之内：假性白细胞减少症，各种类型白血病，再…     

PEG-rhG-CSF预防化疗后中性粒细胞减少症的随机对照临床研究

目的:比较聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)和重组人粒细胞集落刺激因子(rhG-CSF)预防化疗后中性粒细胞减少症的有效性和安全性。方法:采用随机开放、平行分组的方法,乳腺癌患者接受1个周期TAC方案化疗,随机分配到60、100、120μg/kg PEG-rhG-CSF组和5μg/(kg.d)rhG-CSF组。结果:共入组12例,5μg/(kg.d)rhG-CSF对照组和60、100、120μg/kg PEG-rhG-CSF试验组患者ANC<1.5×109/L分别持续1、2、2和2.75 d,中性粒细胞减少症的发生率差异无统计学意义。受试药物的第2峰低于对照药物。结论:PEG-rhG-CSF一次给药的疗效和不良反应与rhG-CSF多次给药相似。     

他巴唑致粒细胞缺乏病5例报告及护理体会

他巴唑是目前临床上最常用于治疗甲状腺机能亢进（甲亢）的药物之一，然而该药可抑制粒细胞在骨髓中生成，造成白细胞减少症或粒细胞缺乏症（粒缺），在临床上有发生。我科于1997年以来有5例甲亢例人在服用巴唑过程中出现粒缺，现将治疗过程及护理体会报告如下。     

预防性使用聚乙二醇化重组人粒细胞集落刺激因子在肺癌患者同步放化疗中的作用

目的 评价预防性使用聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)在肺癌同步放化疗期间预防中性粒细胞减少症的作用。方法 回顾性分析2020年4月至2021年4月于北京大学肿瘤医院接受同步放化疗的149例肺癌患者的临床资料,其中预防组79例,包括初级预防组(全程同步放化疗中预防使用PEG-rhG-CSF)48例,次级预防组(出现粒细胞减少后的化疗周期中预防使用PEG-rhG-CSF)31例;未预防组70例。对比预防组和未预防组之间3~4级中性粒细胞减少症的发生率、同步放化疗完成率、放化疗剂量减量和治疗时间延迟发生率。结果 全组患者在放化疗中出现3~4级中性粒细胞减少症的发生率为32.2%(48/149)。其中,初级预防组的发生率为6.3%(3/48),次级预防组的发生率为9.7%(3/31),未预防组的发生率为35.7%(25/70)。预防组(初级预防+次级预防)与未预防组中性粒细胞减少症的发生率差异有统计学意义(χ²=17.81,P＜0.001)。全组粒细胞缺乏伴发热的发生率为3.4%(5/149),未在初级预防组出现。同步放化疗足量完成率在预防组为96.2%(76/79),明显高于未预防组的82.9%(58/70),差异有统计学意义(χ²=7.30,P=0.007)。预防组放化疗剂量减量和治疗时间延迟发生率为19.0%(15/79),未预防组为40.0%(28/70),差异有统计学意义(χ²=7.98,P=0.005)。结论 PEG-rhG-CSF的预防使用可以有效降低3~4级中性粒细胞减少症的发生,更好地保证肺癌患者同步放化疗按计划完成。     

烧伤败血症患者的中性粒细胞化学光改变

本文使用化学发光技术（CL）观察烧伤败血症患者的中性粒细胞（PMN）功能。结果证实：（1）本症发生与PMN功能障碍有关，绿脓杆菌败血症对后者尤重．（2）PMN与体液免疫因子在功能上相互影响。（3）PMN功能的正常发挥有赖于足够的蛋白热量补充。（4）PMN-CL测定有敏感，快速、无放射性等特点，对探索严重感染发生的原因及评价早期疗效具临床价值。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.