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目的：探讨骨肉瘤AP方案化疗后预防性使用粒细胞集落刺激因子（G-CSF）的时机。方法将90例骨肉瘤患者随机分为3组：化疗后24 h、化疗后48 h及化疗后72 h使用G-CSF组，记录各组患者中性粒细胞计数，了解发生重度中性粒细胞减少的情况，并观察有无发热、口腔黏膜炎及腹泻。结果3组患者发生重度中性粒细胞减少的情况差异具有统计学意义（P﹤0.005）。进行两两分组比较，可见24 h组与48 h组（P﹤0.005）、24 h组与72 h组（P﹤0.05）差异均有统计学意义，而48 h组与72 h组（P﹥0.05）差异无统计学意义。结论在化疗后24 h使用G-CSF，发生重度中性粒细胞减少的风险明显高于化疗后48 h及72 h。“,”Objective To investigate the best timing of prophylactic use of G-CSF after AP chemotherapy for patients with osteosarcoma.Methods 90 patients with osteosarcoma were randomly divided into three groups: using G-CSF 24 h after chemotherapy, 48 h after chemotherapy and 72 h after chemotherapy. Record the absolute neutrophil counts, severe neutropenia, and observe the occurrence of fever, mucositis and diarrhea.Results There was a signiifcant difference (P﹤0.005) between the three groups. Further analysis showed that there were signiifcant difference between 24 h and 48 h group (P﹤0.005), 24 h and 72 h group (P﹤0.05), but not between 48 h and 72 h group (P﹥0.05).Conclusion The risk of severe neutropenia was signiifcantly higher in using G-CSF 24 h after chemotherapy than 48 h and 72 h after chemotherapy.