小儿血液病骨髓活检的临床意义

小儿血液病骨髓活检的临床意义屠立明，沈亦逵，王若洁广东省人民医院儿科ＣＬＩＮＩＣＳＩＧＮＩＦＩＣＡＮＣＥＯＦＢＯＮＥＭＡＲＲＯＷＢＩＯＰＳＹＩＮＣＨＬＬＤＲＥＮＨＥＭＡＴＯＬＯＧＩＣＤＩＳＥＡＳＥＳ￥ＴｕＬｉｍｉｎｇ，ｅｔａｌ．（ＧｕａｎｇｄｏｎｇＰ...

CLINIC SIGNIFICANCE OF BONE MARROW BIOPSY IN CHLLDREN HEMATOLOGIC DISEASES

Abstract:Summarized and discussed the results of 180 times/cases bone marrow(BM)smears andbone marrow biopsies as well in 149 cases of hematologic diseases in children. In 26 cases ofaslantic anemia (AA ) only 14 (54 % ) the diagnosis could be confirmed through tiM smears.But by combining BM smears with BM biopsies, the AA diagnosis were clearly recognized inall cases. The diagnosis of AA by BM biopsy is according to the rate of fat tissue in BM.In 65 cases of acute leukemia (Al.), 8 cases were out of diagnostic requirement in BMsmears because of the secondary Ba fibrosis, AM necrosis and contamination of peripheralblood. These 8 cases all were correctly diagnosed through tiM biopsles and their secondarypathologic changes in BM were also discovered.In 17 cases of All the BM smears showed complete recovery after treatment. But amongthese there were 8 cases the BM biopsies did not give the normal appearence by showing theirpremature cells in cluster or focus distribution. BM biopsy is also a very useful method to diagnose some other hematologic diseases, such as MDS,lymphoma, etc.This investigation suggests that by combining tiM smear with BM biopsy to diagnoseand evaluate the results of treatment in children hematologic diseases, of which the mainpathologic changes are in the bone marrow, such as AA and AL, is better than using onlyBM smear, especially for the AA. BM biopsy is also helpful to discover some secondary BMpathologic changes in children hematologic diseases, e. g. BM fibrosis, BM necrosis, so as torule out the pseudo-negative results from BM smears which may be influenced by these factors.