急性白血病并发颅内出血死亡58例临床分析
急性白血病；,颅内出血；,血小板减少；,高白细胞血症,,急性白血病；,颅内出血；,血小板减少；,高白细胞血症,摘要,关键词,1资料和方法,2结果,3讨论
摘要: 目的：探讨急性白血病(AL)颅内出血机制和危险因素。方法：对1995年1月~2004年12月期间收治的58例AL合并颅内出血死亡病例进行回顾性分析，将病例分为早期死亡组(ED)和非早期死亡组(NED)，观察颅内出血时病人的血小板和白细胞数以及有无感染和贫血。 结果：颅内出血是导致AL死亡和早期死亡的主要原因；颅内出血的原因与严重的血小板减少、高白细胞血症、感染、贫血有关； ED组颅内出血死于血小板减少者明显高于NED组(P<0.05)。颅内出血与AL分型有关， M3可作为AL颅内出血的危险因素，原发病未控制及化疗也是颅内出血的危险因素。结论：临床上确认和识别颅内出血的先兆对于防治颅内出血有重要意义，对于危险因素应及时采取措施，有助于提高AL的缓解率，降低死亡率。关键词: 急性白血病； 颅内出血； 血小板减少； 高白细胞血症
Clinical analysis of the intracranial hemorrhage of acute leukemiasHAO Jianping, FU Meilan
(Department of Hematology， First Affiliated Hospital， Xingjiang Medical University,Urumqi 830054, China)
Abstract: Objective： To study mechanism and risk factors of intracranial hemorrhage of acute leukemias(AL). Methods: Fiftyeight patients with AL who died of intracranial hemorrhage from January 1995 to December 2004 were reviewed, divided cases between the early death (ED) group and NED group. WBC, BPC, Hb and temperature were determined. Results: Intracranial hemorrhage was the main cause of death, the cause of intracranial hemorrhage were thrombocytopenia, hyperleukocytosis, fever and anemia. Intracranial hemorrhage was the main cause of early death, was thrombocytopenia, significantly higherthan NED group (P<0.05). AL type was associated with intracranial hemorrhage, M3 might be the high risk factors for death. Chemotherapy and failure to control underlying disease were also risk factors. Conclusion: Some prodromal bleeding presentation of intracranial hemorrhage should be found. It should be take measures for those risk factors to decreased the death rate. ......
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