Nearly 40% of patients will have skin itching, especially after scratching in warm water bath.PV patients often have digestive tract discomfort, mainly including upper abdominal discomfort,gastroscopeIndicating stomachduodenumErosion, etc., presumably related toBlood viscosityIncreasegastric mucosaAbnormal blood supply.
It is associated with significantly slow blood flow, especially withThrombocytosisThere may be thrombosis and infarction.Thrombosis is most common in limbsmesentery, Brain andCoronary vessel, paralysis symptoms may occur in severe cases.
Due to vascular congestion, intimal injury andplateletFactor 3 decreasesclotThere may be bleeding tendency due to poor retraction and other reasons.Most common in skinEcchymosis、Gingival bleeding, sometimes trauma orPostoperative bleedingMore than that.
The purpose of treatment is to makeBlood volumeAnd red blood cell volume close to normal, inhibit bone marrowHematopoietic functionSo as to alleviate the disease and reducecomplication。
1. Venous bleeding
It can reduce the blood volume to normal in a short time, relieve symptoms, and reduce the chance of bleeding and thrombosis.Bleed 200-400ml every 2-3 days untilRed blood cell countAt 6.0 × 10twelve/Below L, hematocrit is below 50%.One blood letting can maintain the curative effect for more than 1 month.This method is simple and can be used first.Younger patients without thrombotic complications can be treated by bloodletting alone.However, it is possible to increase the rebound of red blood cells and platelets after blood letting. Repeated blood letting also tends to aggravate iron deficiency, which should be paid more attention.For the elderly and patients with cardiovascular disease, blood letting should be cautious, and the blood letting should not exceed 200~300ml at a time, and the interval can be slightly extended.blood corpuscleA large number of red blood cells can be collected separately, but plasma of the same type with the same volume should be supplemented. When bleeding, intravenous fluid should be supplemented at the same time to dilute the blood.
(1) HydroxyureaIt is a ribonucleic acid reductase, which is good for polycythemia verainhibition, without causingleukemiaside reaction。asWhite blood cell countMaintain at 3.5~5 × 10nine/50. The hydroxyurea can be applied intermittently for a long time.
(3) HarringtonineIt is reported in China that this product is added to 10% glucose solutionIntravenous dripOnce a day, continuously or intermittently until hematocrit and hemoglobin are reduced to normal.Achieve mitigationTime average60 days, and the median remission period is more than 18 months.
interferonyesSuppressor cellThe effect of proliferation has also been used for the treatment of this disease in recent years.subcutaneous injectionAfter 3 months of treatment, the spleen shrank and the number of bleeding decreased.Remission rateUp to 80%.
4. Radionuclide therapy
32PBeta rayCan inhibit cellsMitosis, reducing the number of cells.After about 6 weeks, the number of red blood cells began to decline, and it was close to normal after 3 to 4 months. The symptoms were relieved, and about 75% to 80% of patients were effective.If the disease is not relieved after 3 monthsAdministrationonce.The remission time was 2-3 years.32P has the risk of transforming patients into leukemia, so it has been rarely used in recent years.
