成人造血干细胞输注管理的最佳证据总结

doi:10.3761/j.issn.2096-7446.2026.07.017

摘要/Abstract

摘要：

目的汇总成人造血干细胞输注管理的最佳证据。方法按照证据金字塔“5S”模型，系统检索指南库、专业学会及国内外数据库中的临床决策、指南、最佳实践、专家共识、证据总结、系统评价及原始研究，文献检索时限为建库至2025年9月30日。由2名研究者分别对文献进行质量评价、证据提取和整合。结果共纳入13篇文献，包括1篇临床决策、2篇指南、5篇专家共识、2篇团体标准、1篇证据总结、2篇类实验研究。从机构与人员资质管理要求、输注前评估、输注中质量控制、监测与记录、输注相关不良反应处理、健康教育6个方面共汇总了35条最佳证据。结论该研究系统、全面地总结了成人造血干细胞输注管理的最佳证据，建议临床医护人员根据造血干细胞类型，结合患者年龄、合并症，个性化选择和应用最佳证据，提高成人造血干细胞输注的安全性和规范性。

关键词: 造血干细胞, 输注, 管理, 证据总结, 循证护理

Abstract:

Objective To summarize the best evidence on hematopoietic stem cell infusion management. Methods According to the “5S” model of the evidence pyramid，clinical decisions，evidence summaries，best practices，guidelines，expert consensus，and systematic reviews and original studies on adult hematopoietic stem cell infusion management in domestic and foreign databases and relevant professional websites were systematically searched. The time limit for literature retrieval was from establishment of databases to September 30 2025. Two researchers independently conducted quality assessment，evidence extraction，and integration of the literature. Results A total of 13 literature were included，including a clinical decision，two guidelines，five expert consensuses，two group standard，a evidence summary，and two quasi-experimental studies. 35 best evidences were summarized from 6 aspects，including institutional and personnel qualification management requirements，pre-infusion assessment，infusion quality control，monitoring and documentation，management of infusion-related adverse reactions，and health education. Conclusion This study systematically and comprehensively summarizes the best evidence for adult hematopoietic stem cell infusion management. It is recommended that clinical healthcare providers select and apply the best evidence based on the type of stem cells，combined with the patient’s age and comorbidities，to improve the safety and standardization of adult hematopoietic stem cell infusion.

Key words: Hematopoietic Stem Cells, Infusion, Management, Evidence Summary, Evidence-Based Nursing

谢彩琴, 段浩然, 王云花, 郝芳芳, 张颖, 陈文思, 张建霞, 王荔歆. 成人造血干细胞输注管理的最佳证据总结[J]. 中华急危重症护理杂志, 2026, 7(7): 877-884.

XIE Caiqin, DUAN Haoran, WANG Yunhua, HAO Fangfang, ZHANG Ying, CHEN Wensi, ZHANG Jianxia, WANG Lixin. Summary of the best evidence on adult hematopoietic stem cell infusion management[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(7): 877-884.

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参考文献 30

[1]	Astigarraga CC, Mpms K, Iovino L, et al. Haploidentical trans-plantation:an optimal platform for graft manipulation and cel-lular therapies[J]. Blood Rev, 2025, 72:101286.
[2]	Kenyon M, Babic A. The European blood and marrow trans-plantation textbook for nurses:under the auspices of EBMT[M]. Cham: Springer International Publishing, 2018:91-100.
[3]	中华医学会血液学分会造血干细胞应用学组. 成人急性白血病自体造血干细胞移植中国专家共识(2024年版)[J]. 中华血液学杂志, 2024, 45(7):637-644.
	Hematology Branch of Chinese Medical Association,Hema-topoietic Stem Cell Application Group. Chinese consensus on autologous stem cell transplantation for adult acute leukemia (2024)[J]. Chin J Hematol, 2024, 45(7):637-644.
[4]	Boulanger F, Decot V, Bulliard G, et al. Modalities for prepara-tion,cryopreservation,thawing of hematopoietic stem cells and precautions for infusion to patient:guidelines from the Franco-phone Society of Bone Marrow Transplantation and Cellular Therapy(SFGM-TC)[J]. Bull Cancer, 2016, 103(11S):S267-S272. doi: 10.1016/j.bulcan.2016.09.002
[5]	Scaradavou A, Avecilla ST, Tonon J, et al. Guidelines for cord blood unit thaw and infusion[J]. Biol Blood Marrow Transplant, 2020, 26(10):1780-1783. doi: 10.1016/j.bbmt.2020.06.018
[6]	中华医学会血液学分会, 中国临床肿瘤学会(CSCO)抗淋巴瘤联盟. 淋巴瘤自体造血干细胞动员和采集中国专家共识(2020年版)[J]. 中华血液学杂志, 2020, 41(12):979-983.
	Chinese Society of Hematology,Chinese Society of Clinical On-cology(CSCO) Anti-Lymphoma Alliance. Consensus of Chinese experts on the mobilization and collection of autologous hema-topoietic stem cells in lymphoma(2020)[J]. Chin J Hematol, 2020, 41(12):979-983.
[7]	邢唯杰, 周英凤, 朱政, 等. 证据金字塔的发展:从“6S”模型到“5S”模型[J]. 护士进修杂志, 2025, 40(13):1345-1348.
	Xing WJ, Zhou YF, Zhu Z, et al. Evolution of the evidence pyramid:from the “6S” model to the “5S” model[J]. J Nurses Train, 2025, 40(13):1345-1348.
[8]	Foster MJ, Shurtz S. Making the Critical Appraisal for Sum-maries of Evidence(CASE) for evidence-based medicine(EBM):critical appraisal of summaries of evidence[J]. J Med Libr Assoc, 2013, 101(3):192-198. doi: 10.3163/1536-5050.101.3.008
[9]	Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ:advan-cing guideline development,reporting and evaluation in health care[J]. CMAJ, 2010, 182(18):E839-E842.
[10]	周英凤, 胡雁, 朱政, 等. JBI循证卫生保健中心文本证据的质量评价清单[J]. 护士进修杂志, 2024, 39(10):1075-1080.
	Zhou YF, Hu Y, Zhu Z, et al. Critical appraisal checklist for textual evidence developed by JBI Center of Evidence-Based Health Care[J]. J Nurses Train, 2024, 39(10):1075-1080.
[11]	周英凤, 顾莺, 胡雁, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具:干预性研究的质量评价(二)[J]. 护士进修杂志, 2018, 33(2):112-113.
	Zhou YF, Gu Y, Hu Y, et al. JBI evidence-based health cen-ter’s quality assessment tool for different types of research:quality evaluation of intervention research[J]. J Nurses Train, 2018, 33(2):112-113.
[12]	周英凤, 顾莺, 胡雁, 等. JBI循证卫生保健中心关于不同类型研究的质量评价工具:干预性研究的质量评价(一)[J]. 护士进修杂志, 2018, 33(1):24-26.
	Zhou YF, Gu Y, Hu Y, et al. Quality assessment tool of diffe-rent types of research for JBI evideuce based health care:quality evaluation of intervention study[J]. J Nurses Train, 2018, 33(1):24-26.
[13]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
	Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train, 2015, 30(11):964-967.
[14]	脐带血临床输注专家共识编写组. 脐带血临床输注专家共识[J]. 中华保健医学杂志, 2025, 27(2):181-185.
	Expert Consensus on Clinical Infusion of Cord Blood. Expert consensus on clinical infusion of cord blood[J]. Chin J Health Care Medicine, 2025, 27(2):181-185.
[15]	中国医药生物技术协会. 自体造血干细胞移植规范[J]. 中国医药生物技术, 2022, 17(1):75-93. doi: 10.3969/j.issn.1673-713X.2022.01.016
	China Medical Biotechnology Association. Guideline for autolo-gous hematopoietic stem cell transplantation[J]. Chin Med Bio-technol, 2022, 17(1):75-93.
[16]	Milczarek S, Kulig P, Zuchmańska A, et al. Safety of cryopre-served stem cell infusion through a peripherally inserted central venous catheter[J]. Cancers, 2023, 15(4):1338. doi: 10.3390/cancers15041338
[17]	Huang L, Song GQ, Wu Y, et al. Optimal length of time of cryopreserved umbilical cord blood infusion after thawing[J]. Hematology, 2014, 19(2):73-79. doi: 10.1179/1607845413Y.0000000101 pmid: 23684058
[18]	Robert S, Negrin M. Sources of stem cells/group cells for he-matopoietic stem cell transplantation[EB/OL].(2025-07-21)[2025-10-30]. https://www.uptodate.cn/contents/zh-Hans/hemato-poietic-cell-transplantation-hct-sources-of-hematopoietic-stempro-genitor-cellssearch=stemcell%2FSourcesofstemcells/groupcells&source=search_result&selectedTitle=3-150&usa-ge_type=default&display_rank=3.
[19]	孟珠, 姜艳鑫, 张歆睿, 等. 成人患者输血通路选择及管理最佳证据总结[J]. 护理学杂志, 2025, 40(17):49-53.
	Meng Z, Jiang YX, Zhang XR, et al. Summary of the best evidence for selection and management of blood transfusion ac-cess in adult patients[J]. J Nurs Sci, 2025, 40(17):49-53.
[20]	郭智, 王钧. 造血干细胞移植临床实践整体评估中国专家共识(2025年版)[J/OL]. 中国医学前沿杂志(电子版), 2025,17(6):1-13.
	Guo Z, Wang J. Chinese expert consensus on comprehensive assessment of clinical practice in hematopoietic stem cell transplantation(2025 edition)[J/OL]. Chin J Front Med Sci Electron Version, 2025,17(6):1-13.
[21]	中国医学装备学会. 造血干细胞移植病房建设与配置标准:T/CAME 49-2022[S]. 2022.
	China Medical Equipment Society. Construction and configura-tion standards for hematopoietic stem cell transplantation wards:T/CAME 49-2022[S]. 2022.
[22]	国家卫生健康委. 异基因造血干细胞移植技术临床应用管理规范(2022年版)[EB/OL].(2022-05-01)[2026-03-16]. http://www.nhc.gov.cn/yzygj/s7657/202204/2efe9f8ca13f499c8e1f70844fe96144.shtml.
	National Health Commission. Clinical application management specifications for allogeneic hematopoietic stem cell trans-plantation technology(2022 edition)[EB/OL].(2022-05-01)[2026-03-16]. http://www.nhc.gov.cn/yzygj/s7657/202204/2efe9-f8ca13f499c8e1f70844fe96144.shtml.
[23]	Barker JN, Kurtzberg J, Ballen K, et al. Optimal practices in unrelated donor cord blood transplantation for hematologic malignancies[J]. Biol Blood Marrow Transplant, 2017, 23(6):882-896. doi: 10.1016/j.bbmt.2017.03.006
[24]	Lengefeld J, Cheng CW, Maretich P, et al. Cell size is a de-terminant of stem cell potential during aging[J]. Sci Adv, 2021, 7(46):eabk0271.
[25]	Australian and New Zealand Society of Blood Transfusion, Australian College of Nursing. Guidelines for the administra-tion of blood products[EB/OL].(2025-07-11)[2025-10-30]. https://anzsbt.org.au/wp-content/uploads/2024/02/Guidelines-for-the-Administration-of-Blood-Products-revised-Feb-2024.
[26]	蓝红, 唐雅琴. 异基因外周血干细胞回输不良反应的观察及护理[J]. 当代护士(上旬刊), 2020, 27(4):42-44.
	Lan H, Tang YQ. Observation and nursing care of adverse reactions of allogeneic peripheral blood stem cells reinfusion[J]. Today Nurse, 2020, 27(4):42-44.
[27]	车红. 深低温冷冻冻存自体造血干细胞复苏后输注在自体移植中相关护理的研究进展[J]. 航空航天医学杂志, 2023, 34(7):828-830.
	Che H. Research progress on related nursing care of autolo-gous hematopoietic stem cells cryopreserved after resuscitation in autologous transplantation[J]. J Aerosp Med, 2023, 34(7):828-830.
[28]	Poder TG, Nonkani WG, Tsakeu Leponkouo é. Blood warming and hemolysis:a systematic review with meta-analysis[J]. Trans-fus Med Rev, 2015, 29(3):172-180.
[29]	李宗龙, 侯忱, 司宇, 等. 从“输血”到“用血”:《临床用血技术规范(2025年版)》解析[J]. 中国输血杂志, 2026, 39(1):8-15.
	Li ZL, Hou C, Si Y, et al. From blood transfusion to blood use:an analysis of the Technical Specifications for Clinical Use of Blood(2025 Edition)[J]. Chin J Blood Transfus, 2026, 39(1):8-15.
[30]	肖文文, 刘博宁, 王婷. 造血干细胞移植病人保护性隔离期间恐惧的研究进展[J]. 护理研究, 2024, 38(22):4068-4071.
	Xiao WW, Liu BN, Wang T. Research progress on fear in patients undergoing hematopoietic stem cell transplantation during protective isolation[J]. Chin Nurs Res, 2024, 38(22):4068-4071.