7wu1wm0 发表于 2024-6-23 02:28:25

再突破！75岁高龄多发性骨髓瘤病人在我院成功完成自体造血干细胞移植！


    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">近期，一名75岁多发性骨髓瘤<span style="color: black;">病人</span></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在我院顺利完成</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">自体造血干细胞移植，<span style="color: black;">恢复</span>出院</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这<span style="color: black;">亦</span>是我院自体移植的</span><span style="color: black;"><strong style="color: blue;">最高龄<span style="color: black;">病人</span></strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_gif/B2sqLctEnoTK5ED6QYibDnEX7ESribPTh1c79Q5wRcXHlhbStyuiaHFViaEgTW3rbwc1HpHdic4ic780ZVyYVp5Fog4g/640?wx_fmt=gif&amp;from=appmsg&amp;wxfrom=5&amp;tp=webp&amp;wx_lazy=1&amp;wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一向体健的陆大爷（化名）在去年7月<span style="color: black;">起始</span><span style="color: black;">显现</span></span><strong style="color: blue;"><span style="color: black;">乏力</span></strong><span style="color: black;">等症状，到医院<span style="color: black;">检测</span>后<span style="color: black;">发掘</span></span><span style="color: black;"><strong style="color: blue;">中度贫血</strong></span><span style="color: black;">，血常规提示血红蛋白仅60g/L。但当时陆大爷并未<span style="color: black;">留意</span>，直至</span><strong style="color: blue;"><span style="color: black;">牙龈<span style="color: black;">流血</span></span></strong><span style="color: black;">才再次来到我院血液科就诊，完善骨髓、血液、尿液等检查后确诊为</span><span style="color: black;"><strong style="color: blue;">多发性骨髓瘤</strong></span><span style="color: black;">。经过5个疗程的化疗后，陆大爷血液、尿液中的<span style="color: black;">反常</span>指标均<span style="color: black;">掌控</span>在正常范围，达到</span><span style="color: black;"><strong style="color: blue;">部分缓解</strong></span><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">自体造血干细胞移植</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">多发性骨髓瘤是一种血液系统的恶性肿瘤，即便后续维持常规治疗，仍然</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">没</span>法根治</span></strong><span style="color: black;">，大<span style="color: black;">都数</span><span style="color: black;">病人</span>面临</span><strong style="color: blue;"><span style="color: black;">复发的<span style="color: black;">危害</span></span></strong><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">自体造血干细胞移植</strong></span><span style="color: black;">是多发性骨髓瘤<span style="color: black;">病人</span>的</span><span style="color: black;"><strong style="color: blue;">首选巩固治疗<span style="color: black;">办法</span></strong></span><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因为</span>造血干细胞来自患者<span style="color: black;">自己</span>，不会<span style="color: black;">出现</span>移植物排斥和移植物抗宿主病，移植并发症少，移植<span style="color: black;">关联</span><span style="color: black;">危害</span>低，移植后生活质量好，可</span><span style="color: black;"><strong style="color: blue;"><span style="color: black;">显著</span>延长<span style="color: black;">病人</span><span style="color: black;">存活</span>期</strong></span><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">思虑</span>到陆大爷属于基因学高危组，在血液科李炳宗<span style="color: black;">专家</span>团队和<span style="color: black;">病人</span>、家属的协商下，决定为其进行自体造血干细胞移植。</span></p><strong style="color: blue;">
      <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">体检</span></p>
    </strong>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">全面<span style="color: black;">检测</span>，确定<span style="color: black;">病人</span><span style="color: black;">无</span>活动性感染或脏器功能的<span style="color: black;">损害</span>。</span></p><span style="color: black;"><strong style="color: blue;">采集</strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">运用</span>动员剂将骨髓中的造血干细胞动员至外周血，达到<span style="color: black;">必定</span>标准后连接</span><strong style="color: blue;"><span style="color: black;">采干分离机</span></strong><span style="color: black;">进行干细胞采集。并将采集的自体造血干细胞冷冻<span style="color: black;">保留</span>备用。</span></p><span style="color: black;"><strong style="color: blue;">预处理</strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">病人</span>药浴后进入移植仓，接受大剂量化疗以杀死骨髓中所有的瘤细胞。</span></p><span style="color: black;"><strong style="color: blue;">回输</strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">将造血干细胞回输至<span style="color: black;">病人</span><span style="color: black;">身体</span>，<span style="color: black;">通常</span>在回输干细胞后10天<span style="color: black;">上下</span>干细胞<span style="color: black;">起始</span><span style="color: black;">移植</span>，<span style="color: black;">自己</span>造血及免疫功能逐步恢复。</p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/B2sqLctEnoTK5ED6QYibDnEX7ESribPTh1vnib2L8serNWNTII8KYBaiaH24ny4tz8lXyvE5OXt38CHx9UKEtPrXbA/640?wx_fmt=jpeg&amp;from=appmsg&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;"></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">（图为自体造血干细胞采集）</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因为</span>已超过65岁自体移植的常规年龄</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">这里</span>过程中<span style="color: black;">病人</span>免疫力下降</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">很可能<span style="color: black;">导致</span>一系列并发症</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">为此血液科团队制定严谨、<span style="color: black;">仔细</span>的移植计划</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">每一个</span>环节密切关注<span style="color: black;">病人</span>身体<span style="color: black;">情况</span></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">令人欣慰的是，陆大爷并未<span style="color: black;">显现</span></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">电解质<span style="color: black;">错乱</span>、低蛋白血症等并发症</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">近期</span>，陆大爷来到医院复查</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">各项<span style="color: black;">反常</span>指标均已恢复正常，疗效<span style="color: black;">评定</span></span><span style="color: black;"><strong style="color: blue;">完全缓解</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/B2sqLctEnoTK5ED6QYibDnEX7ESribPTh1d17NyK1Jw73RvN0YWAe4xp7ex6eBnfh9mUECgKrgk63SRJ3m3icJvicA/640?wx_fmt=other&amp;from=appmsg&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;"></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">（<span style="color: black;">病人</span>移植后复查：免疫固定电泳、血清游离轻链、尿轻链都是阴性，疗效<span style="color: black;">评定</span>完全缓解）</span></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/7QRTvkK2qC4ia5UrsIrkGrdzLz4x5Nbv7F8m1CQmrcTyM2C93TQoITGibV8TL7dJYbPS0I7SWC4mjCXAzUTJegqQ/640?wx_fmt=gif&amp;wxfrom=5&amp;wx_lazy=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;">
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">多发性骨髓瘤是一种血液系统恶性肿瘤</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">好发于中老年人</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">临床</span><span style="color: black;"><strong style="color: blue;">表现<span style="color: black;">繁杂</span>多样</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">初期</span>症状</span><span style="color: black;"><strong style="color: blue;">易与其他老年<span style="color: black;">平常</span>病混淆</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">容易<span style="color: black;">引起</span>误诊</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">其核心症状</span><span style="color: black;">可概括为</span><span style="color: black;"><strong style="color: blue;">CRAB</strong></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">英文中是螃蟹的意思</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因此呢</span><span style="color: black;">亦</span>被<span style="color: black;">叫作</span>为</span><strong style="color: blue;"><span style="color: black;">“螃蟹病”</span></strong></p><strong style="color: blue;"><span style="color: black;">C：高钙血症&nbsp;</span></strong>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">骨质的<span style="color: black;">海量</span>溶解<span style="color: black;">引起</span>血钙<span style="color: black;">升高</span>。症状<span style="color: black;">无</span>特异性，<span style="color: black;">包含</span>乏力、虚弱、恶心呕吐、腹痛、骨痛，严重者可<span style="color: black;">引起</span><span style="color: black;">尿多</span>、<span style="color: black;">认识</span>不清和<span style="color: black;">晕倒</span>。</span></p><span style="color: black;"><span style="color: black;"><strong style="color: blue;">
                <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">R：肾功能<span style="color: black;">反常</span>&nbsp;</span></strong></span></p>
            </strong></span></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">部分<span style="color: black;">病人</span>可<span style="color: black;">显现</span>腰酸、<span style="color: black;">泡泡</span>尿、尿量减少、浮肿等肾功能不全表现，如不<span style="color: black;">即时</span>接受正确治疗可能<span style="color: black;">引起</span>肾衰竭。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;"><strong style="color: blue;">A：贫血</strong></span></span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">表现为<span style="color: black;">头昏</span>、乏力、面色苍白等“贫血”症状。</span></p><span style="color: black;"><span style="color: black;"><strong style="color: blue;">B：骨病</strong></span></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">重点</span></span><span style="color: black;">表现</span><span style="color: black;">为</span><span style="color: black;">骨质疏松</span><span style="color: black;">和</span><span style="color: black;">骨骼</span><span style="color: black;">破坏。骨痛、骨折等且骨科治疗后不见成效</span><span style="color: black;">。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">除此之外，多发性骨髓瘤<span style="color: black;">病人</span>还可<span style="color: black;">伴同</span></span><strong style="color: blue;"><span style="color: black;">反复感染</span></strong><span style="color: black;">、</span><strong style="color: blue;"><span style="color: black;">发热</span></strong><span style="color: black;">、</span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">流血</span></span></strong><span style="color: black;">等症状。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">日前</span>，多发性骨髓瘤的发病率<span style="color: black;">逐步</span><span style="color: black;">上升</span>，<span style="color: black;"><span style="color: black;">重点</span><span style="color: black;">出现</span>于50岁以上的中老年人，<span style="color: black;">因此</span>这部分人群一旦<span style="color: black;">显现</span>症状，应<span style="color: black;">即时</span>到正规医院专科就诊。</span></span></p><img src="https://mmbiz.qpic.cn/mmbiz_gif/7QRTvkK2qC4ia5UrsIrkGrdzLz4x5Nbv7F8m1CQmrcTyM2C93TQoITGibV8TL7dJYbPS0I7SWC4mjCXAzUTJegqQ/640?wx_fmt=gif&amp;wxfrom=5&amp;wx_lazy=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;">
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">血液科</strong></span></p><img src="https://mmbiz.qpic.cn/sz_mmbiz_jpg/B2sqLctEnoTP97Tgfkf104sMicic21QlmOIBiabAJphO9MqdZIZJ2bToyaSnQVsChXLTzFicYp6DCCTLYSwCZ0Sp1g/640?wx_fmt=other&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;">
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">我院血液科<span style="color: black;">日前</span>已形</span><span style="color: black;">成淋巴肿瘤（淋巴瘤中心）和白血病/骨髓衰竭性<span style="color: black;">疾患</span>两个亚专科，做到精益求精、规范诊治。对淋巴系统肿瘤（淋巴瘤、骨髓瘤）、急</span><span style="color: black;">慢性白血病、骨髓衰竭性<span style="color: black;">疾患</span>（再生<span style="color: black;">阻碍</span>性贫血、骨髓增生<span style="color: black;">反常</span>综合症）、骨髓增殖性肿瘤（真性红细胞<span style="color: black;">增加</span>症、原发性血小板<span style="color: black;">增加</span>症、骨髓纤维化）和出凝血系统<span style="color: black;">疾患</span>的诊断和规范化治疗均达到国内外先进水平。常规开展</span><strong style="color: blue;"><span style="color: black;">自体造血干细胞移植</span></strong><span style="color: black;">和</span><strong style="color: blue;"><span style="color: black;">异基因造血干细胞移植</span></strong><span style="color: black;">，<span style="color: black;">同期</span>针对复发难治性淋巴浆细胞肿瘤开展CD19和BCMA等多靶点的</span><strong style="color: blue;"><span style="color: black;">CART细胞免疫治疗</span></strong><span style="color: black;">，是复星凯特和驯鹿CART细胞授权治疗中心。</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">血液实验室常规开展骨髓形态学、骨髓病理、染色体分析（FISH）、流式细胞术、分子生物学和二代基因测序等检测<span style="color: black;">办法</span>，为临床<span style="color: black;">精细</span>诊断和治疗<span style="color: black;">供给</span><span style="color: black;">保证</span>。</span></p><strong style="color: blue;">END</strong><span style="color: black;"><strong style="color: blue;">本期医学专业支持</strong></span>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_png/B2sqLctEnoTP97Tgfkf104sMicic21QlmODfZWtg65icc5tw2g3H14RoT3a5UnLbUuzubXMBlJb7dhj3bTh20wAYQ/640?wx_fmt=png&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;"></a></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><a style="color: black;"><img src="https://mmbiz.qpic.cn/sz_mmbiz_png/B2sqLctEnoTP97Tgfkf104sMicic21QlmOPRTicoYJ6Xu2Z5s7vEnwIbvJMdzCEkWEJOolWZKVy1RsH8g4GUDorQA/640?wx_fmt=png&amp;wxfrom=5&amp;wx_lazy=1&amp;wx_co=1&amp;tp=webp" style="width: 50%; margin-bottom: 20px;"></a></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">文稿：血液科 李希茜、党群工作部/宣传中心 海燕</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">责编：党群工作部/宣传中心 海燕</span></p>
    <p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">审核：血液科 李炳宗、党群工作部/宣传中心 宋萌枝 王宇</span></p>




qzmjef 发表于 2024-10-5 21:59:57

楼主节操掉了，还不快捡起来！
页: [1]
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