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急性白血病和慢性粒细胞白血病的后期,血象中都有白细胞增高,有时原始细胞超过10万/立方毫米成为“原始细胞危蒙”。这时白血病细胞可在大脑皮层的血管内积聚,继而游出血管周围,形成肿瘤样肿块,并能引起颅内出血和梗塞,造成死亡。若血小板计数正常,一般不会发生这种危象。作者认为如原始细胞多于10万/立方毫米,就应采取以下措施: 1.饮水及静脉内补液,使产生大量快速利尿。 2.应用碳酸氢钠碱化尿液,使由于白血病细胞崩解所产生的尿酸的可溶性增加,并从尿中排出。 3.大剂量的别嘌呤醇(800～1200毫克/日),减少肾脏排泄尿酸的负荷。
In the later stages of acute leukemia and chronic myeloid leukemia, white blood cells are elevated in the blood, sometimes more than 100,000 cells / mm3 of primary cells become the “primitive cell crisis.” Leukemic cells accumulate in the blood vessels of the cerebral cortex at this time, and then swim around the blood vessels to form tumor-like masses that can cause intracranial hemorrhage and infarction, resulting in death. If the normal platelet count, this crisis will not happen. The author believes that if the original cells more than 100,000 / cubic millimeter, they should take the following measures: 1. Drinking water and intravenous rehydration, resulting in a large number of rapid diuretic. 2. Use sodium bicarbonate to alkalinate urine to increase the solubility of uric acid produced as a result of disintegration of leukemic cells and excreted from the urine. 3. High-dose allopurinol (800 ~ 1200 mg / day), reduce renal excretion of uric acid load.