中枢神经系统白血病的早期诊断与治疗

EARLY DIAGNOSIS AND TREATMENT OF CENTRAL NERVOUS SYSTEMIC LEUKEMIA

本文对近三年来我院收治的31例白血病儿CNSL发病及治疗情况进行了观察，在31例白血病患儿中发生CNSL16例，占白血病总数的51．6％，其中ALL13例，AML3例，CNSL发生在初诊时或诱导缓解期12例，占总数的75％。我们使用我校自制的FMU－5型细胞玻对离心沉淀器收集CSF中细胞，其细胞收集率80．5％，细胞完整率99．9％，只需10min，临床使用方便、快速；本组16例CNSL分别采用二联鞘注（地塞米松＋氨甲喋呤）及三联鞘注（地塞米松＋氯甲喋呤＋阿糖胞苷），二组病人经治疗后CSF中幼稚细胞消失时间，鞘注次数无明显差异，但三联鞘注后患儿头痛，呕吐、发热的发生率较二联鞘注多。由于观察时间短、例数少、对于二组病人长期缓解率的差异有待继续观察。

We Examined the cerebrospinal fluid (CSF) in 31 leukemic cases using Model FMU-5 Shide Centrifugal Sedimentator, diveded CNS-L cases into two groups, treated with DXM+ MTX and DXM +MTX +Ara-Crespectively, and compared their results. Results: Sixteen (51 % ) of the 31 leukemic cases were diagnosed as central nervous systemic leukemia (CNSL) by Model Fmu-5 Slide Centrifugal Sedimentator. Similar as the two groups were in curative effect, the children treated with the latter were found to have a higher percentage of such side effects as headache, vomit and fever. Conclusion: Model FMU-5 Slid Centrifugal Sedimentator is very helpful in early diagnosis of NCS-L and DXM+MTX is still effective in early treatrment of CNS-L.