儿童血液系统恶性疾病骨髓坏死的临床研究(附4例报告)

Clinical study on bone marrow necrosis in children patients with hematologic malignancies:report of four cases

目的提高对儿童血液系统恶性疾病骨髓坏死的认识。方法回顾性分析临床病例,对病例特点进行总结,讨论骨髓坏死与原发疾病的关系、诊断及预后判断。结果和结论儿童血液系统恶性疾病骨髓坏死常有骨痛、发热、肝脾大、贫血、血小板减少等表现,可发生于病程的不同时期,其预后主要与原发疾病相关,治疗方法以积极控制原发病和对症治疗为主,目前诊断标准以骨髓形态学为主要依据,磁共振及骨髓放射性核素扫描对骨髓坏死的诊断和程度判断有很大的帮助。大剂量糖皮质激素的使用可导致BMN。

Objective To improve the diagnostic accuracy of bone marrow necrosis （BMN）. Methods Retropective clinical cases were analysed. To make a summary of characteristics of BMN. To discuss the relation between BMN and the primary disease, the diagnosis and prognosis, Results and conclusion The BMN patients often present with bone pain, fever, hepatosplenomegly, anemia and thrombocytopenia. Children patients with BMN developed at various phases during the underlying diseases, especially hematologic malignancy, and its prognosis depends greatly on the underlying diseases. Actively controlling the underlying diseases and heteropathy are the primary, treatments. The diagnosis of BMN in made by the typical cytologic findings on bone marrow aspirate and / or the striking histologic picture on trephine biopsy. Nuclear magnetic resonance and bone marrow scaning are help to diagnose BMN and evaluate state of the illness. High-dose glucocorticoid hormones maybe results in BMN.