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目的观察复方丹参注射液联合前列腺素E1、低分子肝素钙及低分子右旋糖酐对造血干细胞移植后肝静脉阻闭塞病(hepatic veno-occlusive disease,HVOD)的预防作用。方法 1998年5月-2009年12月在我院进行造血干细胞移植的患者520例,其中自体外周血干细胞移植231例,同胞间HLA全相合移植125例,非血缘关系HLA全相合/不全相合移植49例,HLA半相合移植115例。采用复方丹参注射液40~60mL,低分子右旋糖酐250~500mL,前列腺素E140~60μg,均每天1次静脉滴注;低分子肝素钙3000~5000IU,每天1次皮下注射;观察对造血干细胞移植后肝静脉闭塞病的预防作用。结果 520例患者,1例发生HVOD并死亡,发生率为0.19%,未发现明显药物不良反应,未出现凝血功能障碍。结论采用复方丹参联合前列腺素E1、低分子肝素钙及低分子右旋糖酐的中西医结合方法可有效预防肝静脉闭塞病。
Objective To observe the preventive effect of compound Danshen injection combined with prostaglandin E1, low molecular weight heparin and low molecular weight dextran on hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation. Methods From May 1998 to December 2009, 520 patients underwent hematopoietic stem cell transplantation in our hospital, including 231 cases of autologous peripheral blood stem cell transplantation, 125 cases of sibling HLA allograft, non-HLA matched all-incompatible transplantation 49 cases, HLA haploidentical transplantation in 115 cases. The compound Danshen injection 40 ~ 60mL, low molecular dextran 250 ~ 500mL, prostaglandin E140 ~ 60μg, were intravenously 1 day; low molecular weight heparin 3000 ~ 5000IU, 1 times a day subcutaneous injection; observe the hematopoietic stem cell transplantation Prevention of hepatic veno-occlusive disease. Results One hundred and 520 patients died of HVOD. The incidence rate was 0.19%. No obvious adverse drug reaction was found and coagulation dysfunction did not occur. Conclusion The combination of compound Salvia miltiorrhiza combined with prostaglandin E1, low molecular weight heparin and low molecular weight dextran can effectively prevent hepatic veno-occlusive disease.