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血小板减少的造血干细胞移植患者在接受物理治疗过程中的出血频率。

Bleeding frequency during physiotherapy in thrombocytopenic patients undergoing hematopoietic stem cell transplantation.

机构信息

Hospital Sírio-Libanês, Rehabilitation Service, São Paulo, Brazil.

Instituto do Câncer de São Paulo (ICESP), São Paulo, Brazil.

出版信息

PLoS One. 2021 Jul 30;16(7):e0255413. doi: 10.1371/journal.pone.0255413. eCollection 2021.

Abstract

BACKGROUND

During hematopoietic stem cell transplantation (HSCT) the patients perform activities of low and moderate intensity because have reduced hematological lineages, leaving them susceptible to hemorrhagic events. The objective of this study was to describe the frequency of bleeding events, severity, and possible association with physical exercise in thrombocytopenic patients.

METHODS

A retrospective study with seventy-seven HSCT patients hospitalised, that had a platelet count ≤ 50,000 /μL and received physical exercise during physiotherapy intervention.

RESULTS

Regarding bleeding events, only six were related to physical exercise, and bleeding events occurred more frequently at platelet levels ≤ 10,000 /μL. The most frequent bleeding event was epistaxis, considered of low severity, and with the moderate possibility of being related to physical exercise; followed by extremity hematoma, considered of medium severity and highly related to physical exercise. In this study, there was no occurrence of bleeding events considered of high severity.

CONCLUSION

Bleeding frequency in supervised physical exercise during physiotherapy in adults with thrombocytopenia undergoing HSCT is minor and relatively rare but occurs more frequently in patients with platelet count ≤10,000 /μL. These results encourage the maintenance of physical activity in this population who is at high risk of developing immobility-related complications.

摘要

背景

在造血干细胞移植(HSCT)期间,患者会进行低强度和中等强度的活动,因为他们的造血谱系减少,容易发生出血事件。本研究的目的是描述血小板减少患者出血事件的频率、严重程度以及与身体活动的可能关联。

方法

对 77 名接受 HSCT 治疗的住院血小板计数≤50000/μL 的患者进行回顾性研究,这些患者在物理治疗干预期间接受了身体锻炼。

结果

关于出血事件,只有 6 起与身体活动有关,且出血事件发生在血小板水平≤10000/μL 时更为频繁。最常见的出血事件是鼻出血,被认为是轻度,且与身体活动中度相关;其次是四肢血肿,被认为是中度严重,且与身体活动高度相关。在本研究中,未发生被认为是重度的出血事件。

结论

在接受 HSCT 的血小板减少症成人中,在物理治疗期间进行监督下的身体锻炼时,出血的频率较低且相对罕见,但在血小板计数≤10000/μL 的患者中更为常见。这些结果鼓励在这个有发生与不活动相关并发症高风险的人群中保持身体活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2247/8323874/4e259fa7521a/pone.0255413.g001.jpg

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