肝移植术后移植物抗宿主病治疗的初步经验_附2例报道_杜国盛.pdfVIP

　 2008 1 33 1 M ed J Chin PLA V ol 33 No 1 Janua y 2008　 ·23 · (2 ) 杜国盛　石炳毅　朱志东　宋继勇　戴新　金海龙 【】　　(GV HD)。　2 GVHD 、、,GV HD , , , 。　2 19、20 、, , 。 1 、, 34 , 。2 GV HD, , , , 、 , , (11 )。　、、GVHD , 、、、。 　　【】　;; 　　【】　R657.3 Preliminary experiences on the treatment graft versus host disease after liver transplantation Du Guosheng, Shi Bingyi, Zhu Zhidong, et al.O gan T ansplantation Cente , Second Affiliated Hospital, Gen- e al Hospital of PLA, Beijing 100091, China 【Abstract 】　Objective　To summa ize the clinical expe iences of diagnosis and t eatment of g aft ve sus host disease (GV HD)in pa- tients, who had unde gone live t ansplantation.Methods　T he clinical symptoms, diagnosis, t eatment and clinical effect of 2 patients with GVHD we e analyzed, including the time of occu ence of GV HD afte ope ation, the sequence of clinical symptoms, the methods of administ ation and the dosage of immunosupp essant, as well as the apeutic measu es when the disease was confi med.Results　Both pa- tients developed unidentified hig h feve , skin ash and gast ointestinal synd omes on the 19th and 20th day, espectively, afte o thotopic live t ansplantation, and then pancytopenia occu ed.The e was no obvious sig ns of live dysfunction du ing the pe iod.One of the two patients died of mixed infection and multiple o gan failu e the 34th day afte the t ansplantation with an inc eased do sage of glucoco ticoid and immunosupp essant.The o the patient was highly suspected of having GVHD at the ea ly pe iod and t eated with small dose of meth- ylp ednisone and immuno supp essant, o completely withheld the immunosupp essant contingent on the condition of the patient.Gamma globulin was used fo upholding the immunity, nasal feeding fo ene gy supplementation, and antibiotics, fungicide and antivi o tics we e administe ed to the patient.This patient was cu ed and still alive and healthy.Conclusions　Patients with u