肿瘤患者化疗后Ⅳ度白细胞减少的治疗

Treatment for patients with grade IV leucopenia after chemotherapy

目的 研究肿瘤患者化疗后IV度白细胞减少的综合救治方法。方法 2 2例患者化疗后发生Ⅳ白细胞减少 ,其中男性 11例 ,女性 11例。升白治疗的综合措施包括保护性隔离、粒细胞集落刺激因子及抗生素的使用。结果 化疗后白细胞计数 0 2× 10 9 L～ 0 96× 10 9 L ,平均 (0 6 6± 0 2 6 )× 10 9 L ,经综合救治后白细胞计数达正常的天数为 3～ 10天 ,平均 (6± 2 )天。体温 38 2～ 4 0 5℃者 12例 ,平均 (39 2 3±0 74 )℃ ,占 5 4 5 % (12 2 2 )。 13 6 % (3 2 2 )发生继发感染 ,死亡 4 5 % (1 2 2 ) ,救治成功率 95 5 % (2 1 2 2 )。结论 化疗后Ⅳ度白细胞减少时及时采取保护性隔离措施 ,合理应用G CSF和 或GM CSF ,积极预防和治疗继发感染 。

Objective To investigate the treatment of grade IV leucopenia after chemotherapy in patients with carcinoma.Methods There were 22 patients who developed grade IV leucopenia after chemotherapy. All of them were given protective isolation, granulocyte colony-stimulating factor, and antibiotics.Results White blood cells count ranged from (0.2～0.96)×10 9/L with an average of (0.66±0.26)×10 9/L after chemotherapy. It returned to a normal level 3 to 10 days after treatment. Twelve patients had a fever and the temperature ranged from 38.2 ℃ to 40.5 ℃ with an average of (39.23±0.74) ℃. Three patients suffered from secondary infection from which 1 patient died. The other 21 patients recovered well at last.Conclusion Patients with grade IV leucopenia as a result of chemotherapy can recover completely if effective therapies are performed timely.