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目的:探讨骨髓活检及骨髓涂片在多发性骨髓瘤诊断中的临床应用。方法:收集初诊并确诊为多发性骨髓瘤的患者中骨髓涂片表现阴性、骨髓活检表现阳性的病例资料,分析其发病过程中表现出的症状、体征及相关辅助检查结果,对比骨髓涂片及活检结果之间的差异,分析骨髓涂片及活检在临床应用中的优点及不足之处。结果:在诊断多发性骨髓瘤时骨髓涂片表现阳性的活检同时均为阳性,而部分骨髓涂片表现为阴性的活检却表现为阳性,故一次性同时进行骨髓涂片及活检有助于降低漏诊率。结论:在多发性骨髓瘤的临床诊断过程中,活检较涂片能更为准确地反应增生程度及肿瘤负荷,且易于发现成堆分布浆细胞灶和异形浆细胞,有较高的临床诊断及评估病情、指导治疗的价值。
Objective: To investigate the clinical application of bone marrow biopsy and bone marrow smears in the diagnosis of multiple myeloma. Methods: The bone marrow smears were negative in patients with newly diagnosed multiple myeloma, and the cases with positive bone marrow biopsy were collected. The symptoms, signs and related auxiliary examinations in the course of their onset were analyzed. The difference between biopsy results, analysis of bone marrow smears and biopsy in the clinical application of the advantages and disadvantages. Results: Biopsy samples with positive bone marrow smears were all positive at the time of diagnosis of multiple myeloma. However, biopsy with negative results of some bone marrow smears showed positive results. Therefore, simultaneous one-time bone marrow smear and biopsy could help to reduce Misdiagnosis rate. Conclusions: In the clinical diagnosis of multiple myeloma, biopsy can reflect the degree of hyperplasia and tumor burden more accurately than the smear, and it is easy to find piles of plasma cells and abnormal plasma cells, which have high clinical diagnosis and Assess the condition, guide the value of treatment.