急性白血病化疗抑制期的出血感染治疗棘手,死亡率高,亦是目前大剂量化疗失败的重要因素。1991年我院开始在常规治疗基础上加用静脉丙种球蛋白,疗效明显,使5例急性白血病化疗抑制期达21天的感染得到控制,2例抑制期有颅内出血患者安全渡过抑制期达完全缓解,现报告如下。 一、一般资料:12例中,男5例,女7例,平均年龄38岁,均为初诊病例。经骨髓检查加组化染色确诊。按天津白血病会议诊断标准,其中M_1 2例,M_2 2例,M_3 2例,M_4 2例,M_5 2例,M_6 1例,慢粒急淋变1例。11例采用DA或HA方案化疗,1例采用VDCP方案化疗。12例化疗抑制期7～21天,白细胞平均最低值0.65×10~(9)/L,血小板平均最低值2.5×10~(9)/L,12例均合并感染(其中上呼吸道感染2例,肺部感染2例,口腔感染5例,腹泻2例,臀部感染1例)。最高体温平均39.8℃,2例高热达40℃时出现头痛、呕吐,轻度意识障碍,1例左口角歪斜左巴氏征(+),另1例布氏征(+)。均经头颅CT证实左丘脑出血破入脑室,1例右底节区小量出血,诊断合并颅内出血。 Treatment of acute leukemia in the suppression of hemorrhagic infection treatment difficult, high mortality, but also an important factor in the failure of large doses of chemotherapy. In 1991, our hospital started to add intravenous gamma globulin on the basis of routine treatment, and the curative effect was obvious. Infection control of 5 cases of acute leukemia with chemotherapy inhibition period of 21 days was controlled, and 2 cases of patients with intracranial hemorrhage during the inhibition period passed the suppression phase safely Completely relieved, the report is as follows. First, the general information: 12 cases, 5 males and 7 females, mean age 38 years old, are newly diagnosed cases. Diagnosed by bone marrow plus histochemical staining. According to the diagnostic criteria of Tianjin leukemia meeting, there were 2 cases of M_1, 2 cases of M_2, 2 cases of M_3, 2 cases of M_4, 2 cases of M_5, 1 case of M_6 and 1 case of acute leiomyoma. Eleven cases were treated with DA or HA regimen and one case received VDCP regimen. 12 cases of chemotherapy inhibition period of 7 to 21 days, the average minimum leucocyte 0.65 × 10 ~ (9) / L, the average platelet mean 2.5 × 10 ~ (9) / L, 12 patients were complicated with infection (including 2 cases of upper respiratory tract infection , 2 cases of pulmonary infection, 5 cases of oral infection, 2 cases of diarrhea, 1 case of buttock infection). The highest body temperature was 39.8 ℃ on average. Two cases of hyperthermia up to 40 ℃ had headache, vomiting and mild disturbance of consciousness. One case had left-sided left-skewed lymph node syndrome (+) and the other had Brinell’s syndrome (+). All confirmed by skull CT hypothalamic hemorrhage broken into the ventricle, a small right hemorrhage in the right end of the area, the diagnosis of intracranial hemorrhage.