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目的探讨骨髓活检切片与骨髓涂片同步观察对全血细胞减少症诊断的临床意义。方法对153例全血细胞减少症患者,采用骨髓穿刺涂片、骨髓活检同步取材,涂片用瑞氏染色,骨髓活检采用塑料包埋、苏木精-姬姆萨-酸性品红染色,同时观察其骨髓涂片和骨髓活检切片。结果 153例中男67例,女86例,年龄3～83岁。血液系统疾病138例(90.2%),非血液系统疾病15例。骨髓活检切片诊断符合率87.58%,高于骨髓涂片71.90%。骨髓活检切片总误诊率为4.58%低于骨髓涂片25.36%。骨髓活检增生程度的判断优于骨髓涂片。结论骨髓活检更能客观地反映骨髓组织的真实情况,特别是在恶性血液系统疾病所致全血细胞减少的诊断、鉴别诊断等方面的价值更优于涂片。骨髓活检与涂片二者联合检测能有效提高全血细胞减少症的诊断准确性。
Objective To investigate the clinical significance of synchronous observation of bone marrow biopsy and bone marrow smear on the diagnosis of pancytopenia. Methods A total of 153 patients with pancytopenia were treated with bone marrow biopsy, bone marrow biopsy, smear with Wright stain, bone marrow biopsy with plastic embedding, hematoxylin-Giemsa-acid fuchsin staining and simultaneous observation Its bone marrow smears and bone marrow biopsy sections. Results 153 cases of male 67 cases, 86 females, aged 3 to 83 years. 138 cases of hematological diseases (90.2%), 15 cases of non-hematological diseases. The coincidence rate of bone marrow biopsy was 87.58%, higher than that of bone marrow smear 71.90%. The total misdiagnosis rate of bone marrow biopsy was 4.58% lower than that of bone marrow smear 25.36%. Bone marrow biopsy better than the degree of bone marrow smear. Conclusion Bone marrow biopsy can objectively reflect the real situation of bone marrow, especially in the diagnosis and differential diagnosis of pancytopenia caused by malignant hematological diseases. Bone marrow biopsy and smear both combined detection can effectively improve the diagnostic accuracy of pancytopenia.