11例同种异体原位心脏移植的回顾性调查  

RETROSPECTIVE ANALYSIS OF 11 CASES WITH ORTHOTOPIC HEART TRANSPLANTATION

作　　者：邹弘麟 蒋立虹 孙小林 陈智豫 李亚雄 韦杰 王萍 

机构地区：[1]昆明市延安医院心胸外科ICU,昆明650051

出　　处：《现代预防医学》2010年第17期3397-3398,F0003,共3页Modern Preventive Medicine

摘　　要：[目的]评估同种异体原位心脏移植治疗终末期心脏疾病的疗效。[方法]对我院2003～2009年期间的11例终末期心脏疾病行心脏移植病人进行回顾性分析,包括术前准备、麻醉、心肌保护、体外循环、术式、术后监护治疗及随访情况,总结心脏移植的经验与教训。[结果]5例病人恢复良好,无并发症,生活自理,其中最长存活时间已达6年;6例死亡,其中术后急性右心衰2例,家中未规律服用免疫排斥药物2例,另外死于院外严重感染及慢性排斥反应各1例。[结论]同种异体原位心脏移植是治疗终末期心脏疾病的一种有效的方法,其中正确的供受体选择、良好的组织配型、有效的心肌保护、精湛的手术技术、严密的围术期管理是病人院内恢复的必备条件,培养自我保健意识及长期规范服用免疫排斥药物是院外长期存活的保障。[Objective] To evaluate the effect of orthotopic heart transplantation on the treatment of end-stage heart diseases. [Methods] 11 patients with end-stage heart diseases and under orthotopic heart transplantation in our hospital between 2003 and 2009 were collected and retrospectively analyzed. The analysis contents included preoperativepreparation, anesthesia, myocardial protection, cardiopulmonary bypass, operation method, monitor and therapy after operation, and follow-up studies. Summarized the experience and lesson about heart transplantation. [Results] Five patients were recovered, with no complications, and can live by themselves. One of them lived for 6 years so far. Six patients were dead, two of them died from acute right heart failure, two died from taking medicine unregularly, one died from infection, and one died from chronic rejection. [Conclusion] Orthotopic heart transplantation is an efficient method to cure end-stage heart disease. The correct choice for acceptor, correct histological matching, effective myocardial protection, good operation skill, and rigorous perioperative period management are all necessary. Consciousness of care protection and taking medicine regularly are necessary for patients.

关 键 词：心脏移植 心肌保护 免疫抑制 

分 类 号：R654.2[医药卫生—外科学]