经寰枕间隙侧方穿刺移植人脐血单个核细胞对难治性神经系统疾病的疗效分析

目的探讨寰枕间隙侧方穿刺术移植人脐血单个核细胞治疗难治性神经系统疾病的可行性和安全性。 方法应用寰枕间隙侧方穿刺术对230例患者进行450次人脐血单个核细胞治疗，观察治疗中及治疗后有无不良反应和并发症，对比治疗前后血液分析、血沉、生化全项、出凝血机制和肿瘤标记物数值，同时观察患者治疗前后病情转归，采用配对比较t检验进行统计学分析。 结果所有患者治疗后均无头痛、感染、皮疹、血肿形成等不良反应和其它移植并发症出现。32例（7.1%）治疗后出现一过性血压升高，8例（1.8%）出现一过性发热，10例（2.2%）穿刺时诉穿刺处深部软组织胀痛，拔针后疼痛消失。患者白细胞计数治疗前（7.9±1.1）×10⁹个/?L和治疗后3个月（8.0±1.3）×10⁹个/L相比差异无统计学意义（t =?0.891，P?=?0.374），谷丙转氨酶治疗前（31.9±5.8）U/L和治疗后3个月（32.4±6.2）U/L相比差异无统计学意义（t?=?0.893，P?=?0.372），球蛋白治疗前（22.1±1.7）g/L和治疗后3个月（21.8±1.8）g/L相比差异无统计学意义（t?=?0.838，P?=?0.066），AFP治疗前（9.9±1.6）μg/L和治疗后3个月（10.1±1.7）μg/L相比差异无统计学意义（t?=?1.299，P?=?0.195），患者血液学指标（血常规+血沉、生化全项、全身肿瘤标记物、病毒筛查、出凝血机制）在治疗前后无统计学差异。183例患者治疗有效，有效率79.6%。 结论寰枕间隙侧方穿刺术移植人脐血单个核细胞治疗难治性神经系统疾病是安全可行并可能有效的。

Safety of transplantation of umbilical cord blood mononuclear cells by the lateral atlanto-occipital space puncture for treatment of refractory neurological diseases

ObjectiveTo investigate the safety and effectiveness of umbilical cord blood mononuclear cells transplantation therapy by the lateral atlanto-occipital space puncture. Methods230 patients have received umbilical cord blood mononuclear cell therapy for 450 times by the lateral atlanto occipital space puncture. The adverse reactions and complications during treatment and after treatment were observed, the hematological parameters were compared before and after treatment, and the patient's condition was observed before and after treatment. Statistical analysis was carried out by two samples compared with t test. ResultAll the patients had no headache, infection, hematoma formation, adverse reactions and other complications after treatment. Transient blood pressure increased after treatment in 32 patients( 7.1%), and transient fever occurred in 8 (1.8%). 10 (2.2%) patients experienced deep soft tissue pain at the time of the puncture. There was no statistical difference (t = 0.891, P = 0.374) between the leukocyte count before (7.9±1.1)and 3 months after treatment (8.0±1.3). There was no statistical difference(t = 0.893, P = 0.372)between the glutamic pyruvic transaminase (μ/L) before (31.9±5.8) and 3 months after treatment (32.4±6.2). There was no statistical difference (t?= ?1.838, P?= ?0.066) between the globulin before (22.1±1.7) and 3 months after treatment (21.8±1.8). There was no statistical difference (t?= ?1.299, P?= ?0.195) between the AFP count before (9.9±1.6) and 3 months after treatment (10.1±1.7) .The hematological indexes (blood routine + ESR, biochemical markers, tumor markers, virus screening, coagulation and coagulation mechanisms) and vital signs of all patients were not statistically different before and after treatment. 183 patients were treated effectively (the effective rate was 79.6%). ConclusionUmbilical cord blood mononuclear cells transplantation therapy by lateral atlanto-occipital space puncture is safe and appears to be benefit for patients.