三例心脏移植的远期心功能  

LongTerm Cardiac Function after Heart Transplantation in 3 Patients

作　　者：臧旺福[1] 夏求明[1] 陈子道[1] 姚志发[1] 向桂玉[1] 祁家驹[1] 蒋树林[1] 杨春文[1] 

机构地区：[1]哈尔滨医科大学第二临床医学院心外科

出　　处：《中国胸心血管外科临床杂志》1997年第4期198-201,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：探讨促进心脏移植患者长期存活的因素。方法２例采用原位心脏移植的标准术式，１例采用全心脏原位移植术。供心用冷Ｓｔ．Ｔｈｏｍａｓ停搏液，冷生理盐水保存；移植期经冠状静脉窦持续逆行灌注含钾温血。结果３例患者恢复满意，已分别存活５年、３年和１年余；随访心电图、心导管、超声心动图和心脏ＥＣＴ等检查均证实心功能正常，射血分数分别为６６．０％、６５．６％和６８．５％；第１例和第３例已从事体力劳动，第２例已恢复整日教学工作。结论正确的手术方法、优良的心肌保护、早期发现急性排斥反应和正确的处理等是提高移植后近。Objective To discuss the factor that improve the patients who underwent heart transplantation for longterm survival.Methods From April 1992 to November 1995,3 patients with late stage cardiomyopathy underwent orthotopic heart transplantation(OHT).Standard OHT were performed on the first and the second patients,and total OHT on the third.The donor hearts were arrested with cold St.Thomas cardioplegia solution,preserved with cold physiological saline .During implantation,the donor heart was preserved by continuous retrograde tepid blood perfusion through coronary sinus.Anastomoses were sutured in a continuous everting fashion.Results All patients survived with good quality of life and resumed their work.They have survived for five years,three years,and more the one year,respectively.ECG,cardiac catheterization,echocardiography,and cardiac ECT had performed for follow up.The results indicate that cardiac function resume normal.The EF were 66.0%,65.6%,and 68.5%,respectively. Conclusion Accurate surgical procedures,enhanced myocardial preservation,early diagnosis and correct treatment of acute rejection are important factors for improvement of early and late therapeutic effect after transplantation.

关 键 词：心脏移植 心功能 心脏外科手术 

分 类 号：R654.2[医药卫生—外科学]