初治儿童急性淋巴细胞白血病出血风险分析

The risk analysis of bleeding in primary children with acute lymphoblastic leukemia

目的:通过回顾性分析初治儿童急性淋巴细胞白血病(ALL)患儿出血时的各项指标,探究ALL患儿出血的相关危险因素,为临床急诊处置提供依据。方法:回顾性分析100例初治ALL患儿(出血组和非出血组各50例)的临床资料及出血相关因素。结果:组间比较显示,出血组与非出血组在白细胞计数、血红蛋白、血小板、体温、既往出血史、平均血小板体积、大血小板比率、血小板分布宽度、细胞免疫异常(包括各亚群之间)方面差异有统计学意义(P<0.05);多因素分析显示,具有既往出血史(P=0.001)及白细胞计数>15×10~9/L(P=0.003)是影响初治ALL患儿出血的独立危险因素。结论:ALL患儿出血高危因素分析对于预测患儿是否出血及预防具有重要意义。

Objective:To investigate the risk factors of bleeding in children with acute lymphoblastic leukemia(ALL)by retrospectively analyzing the indexes of bleeding in children with ALL,so as to provide the basis for clinical emergency treatment.Method:The clinical data and bleeding related factors of 100 children with newly diagnosed ALL were analyzed retrospectively,including 50 cases of hemorrhagic group and 50 cases of non-hemorrhagic group.Result:There were differences in white blood cell count,hemoglobin,platelet,body temperature,past bleeding history,mean platelet volume,large platelet ratio,platelet distribution width and cellular immune abnormality(including each subgroup)between the hemorrhagic group and the non-hemorrhagic group(P<0.05).Multivariate analysis showed that the history of bleeding(P=0.001)and white blood cell count>15×10~9/L(P=0.003)were independent risk factors for bleeding in children with newly diagnosed ALL.Conclusion:The analysis of high risk factors of bleeding in children with ALL is of great significance to predict and prevent bleed.