摘要
目的 探讨最佳的补钙方法以预防外周血造血干细胞(PBSC)采集中的枸橼酸盐中毒(CI).方法 对141例自体患者或异体供者进行了166例次的PBSC采集,按补钙方法不同将患/供者随机分为三组,即口服组(66例次):采集中每小时服1次10%葡萄糖注射液20 ml+10%葡萄糖酸钙20 ml,整个过程口服3～4次;静注组(52例次):采集中每小时静脉缓慢注射1次10%葡萄糖注射液20 ml+10%葡萄糖酸钙10 ml,整个采集过程应用3～4次;静滴组(50例次):采集中静脉持续滴注10%葡萄糖注射液350 ml+10%葡萄糖酸钙30 ml,速度为25～30滴/min,出现CI症状时稍加快滴速.采集中密切观察并记录CI发生情况.结果 口服组CI发生率为28.1%,其中轻度12例次,中度6例次,无重度中毒者,出现CI的平均时间为开始采集后122 min;静注组CI的发生率为18.2%,其中轻度7例次,中度1例次,无重度中毒者,出现CI的平均时间为开始采集后134 min;静滴组CI的发生率为10.0%,均为轻度中毒者,出现CI的平均时间为开始采集后172 min.三组间的CI发生率(χ2=6.612,P＜0.05)及CI程度(χ2=7.290,P＜0.05)的分布比较差异均有统计学意义,其中以静滴组CI的发生率最低、程度最轻,而CI发生时间差异无统计学意义(χ2=1.427,P＞0.05).结论 静脉滴注葡萄糖酸钙是预防造血干细胞采集中枸橼酸盐中毒的最佳方法,其疗效佳和安全性好,值得临床推广应用.
Objective To study the best method of calcium supplementation for preventing citrate intoxication(CI)during peripheral blood stem cell(PBSC)harvesting.Methods According to the different methods of administration of calcium gluconate, 166 procedures of PBSC harvesting in 141 patients/donors were randomly divided into three groups - group oral administration, group intravenous injection and group intravenous drip.In group oral administration(n = 66), 10% calcium gluconate 20 ml in 10% GS 20 ml was administrated by oral one time per hour during harvesting.When symptoms of CI appeared, extra administration was given.In group intravenous injection(n = 52), 10% calcium gluconate 10 ml in 10% GS 20 ml was administrated for intravenous injection per hour during harvesting.When symptoms of CI appeared, extra administration was given.In group intravenous drip(n =50), 10% calcium gluconate 30 ml in 10% GS 350 ml was administrated for intravenous drip at the speed of 25 - 30 drops per minute during harvesting.When symptoms of CI appeared, accelerate the intravenous drip.Symptoms of CI were observed and recorded during harvesting.Results The incidences of CI in three groups were 28.1% , 18.2% and 10.0% in which 12 were mild degree and 6 were moderate degree in group oral administration, 7 were mild degree and 1 was moderate degree in group intravenous injection and all 5 were mild degree in group intravenous drip.The mean time of starting symptoms of CI in group oral administration, group intravenous injection and group intravenous drip were 122 minutes, 134 minutes and 172 minutes.There were statistical differences of the incidence(χ2 =6.612, P ＜0.05＝ and the degrees(χ2=7.290, P ＜0.05)of CI among three groups.Both the incidence and degree of CI was the lowest and lightest in group intravenous drip among the three groups.There was no statistical difference of the mean time of starting CI among the three groups(χ2= 1.427, P ＞ 0.05).Conclusions Intravenous drip of calcium gluconate is the best and safe method for effectively preventing the CI during PBSC harvesting.
出处
《中国实用医刊》
2010年第7期5-7,共4页
Chinese Journal of Practical Medicine
关键词
外周血造血干细胞
采集
枸橼酸盐中毒
补钙
Peripheral blood stem cell
Harvesting/collection
Citrate intoxication
Calcium supplementation
