恶性肿瘤常规剂量化疗后重度骨髓抑制治疗

摘要

Objective:To investigate the treatment of grade Ⅳ bone marrow suppression after conventional chemotherapy.Method:74 cases were analysed the treatment for grade Ⅳ bone marrow suppression after conventional chemotherapy.Result:One per third cases got fever and six cases died of pulmonary infection after treatments of ward ultraviolet disinfection,administration of G-CSF and antibiotics.Those patients with thrombocytopenia were preventively platelet transfusions.At first,57.1% of patients had no lethal hemorrhage.Three weeks later,four cases died of thrombocytopenia inducing hemorrhage,which might be related with the production of platelet antibody.Conclusion:Air disinfection,insulation and these of antibiotics and G-CSF are promising treatments to improve the prognosis of patients with neutropenia.Further research is need to determine the time of preventive platelet transfusions to patients with thrombocytopenia.%目的：探讨常规剂量化疗后Ⅳ度骨髓抑制的治疗。方法：回顾分析笔者所在医院肿瘤内科74例常规剂量化疗后发生Ⅳ度骨髓抑制的治疗。结果：粒细胞减少者，经紫外线病房消毒、G-CSF、抗生素治疗，1/3伴有发热，6例死于肺部感染。血小板减少者，预防性输注血小板，初期57.1%患者有出血现象，均为非致命性，4例3周后血小板低下出血致死，估计与血小板抗体产生有关。结论：粒细胞减少者，积极空气消毒，隔离，抗生素及G-CSF的应用有望改善预后。血小板减少者预防性输注血小板的时机有待进一步研究。