32例造血干细胞移植患者出血的防治

目的研究造血干细胞移植患者出血并发症的防治措施.方法对32例行造血干细胞移植的血液病患者进行回顾性分析,观察其在移植后骨髓空虚期采用的防治出血措施的疗效.结果除1例伴有脾脏肿大的重型β地中海盆血患儿(行无关供者脐血移植)出血症状无好转,血小板数量无明显提高,最终死于颅内出血外,其余31例患者的出血症状均很快得以控制,血小板数量上升,安全度过无髓期.结论在造血干细胞移植后骨髓空虚期,及时采用输注新鲜单采血小板、应用止血药物及糖皮质激素等措施,能够有效控制患者出血并发症的发生.

Prophylactic treatment of hemorrhage in 32 patients after hematopoietic stem cell transplantation

Objective: To study the measures of prevention and treatment for hemorrhagic complications in recipients of hematopoietic stem cell transplantation. Methods: 32 patients with hematological disorders undergoing hematopoietic stem cell transplantation were retrospectively analyzed to observe the effect of methods adopted to prevent and treat hemorrhage during aplastic stage after transplantation. Results: In only one child of β-thalassemia major with splenomegaly undergoing cord blood transplantation from an unrelated donor, that hemorrhagic symptoms were not controlled, platelet counts did not increase significantly and then he died of cerebral hemorrhage. In the other 31 patients, the hemorrhagic symptoms were controlled, platelet counts increased and they totally recovered. Conclusions: During the aplastic stage after hematopoietic stem cell transplantation, transfusion of platelet, anti-hemorrhage drugs and glucocorticoid were proved to be effectual methods to control the hemorrhagic complications of patients.