3例心脏移植的供心保护  

Donor heart protection in heart transplantation(three cases)

作　　者：唐令凤[1] 连丽红[1] 杨康[1] 杨军民[1] 王明荣[1] 曾会昌[1] 

机构地区：[1]第三军医大学西南医院胸心外科,重庆400038

出　　处：《重庆医学》2002年第5期359-360,共2页Chongqing medicine

摘　　要：目的　总结同种原位心脏移植的供心保护方法。方法　采用 4℃Stanford液主动脉根部灌注供心停跳、取出后放入冰盐水中保存 ,2例修剪时经主动脉根部灌注 4℃Stanford液 5 0 0ml,移植过程中间断或持续 2 4～ 30℃去白细胞氧合血灌注。结果　主动脉开放后 1例心脏自动复跳 ,2例经电击复跳 ,术中、术后持续心排监测及B超示心功能指标满意 ,近期随访心功能Ⅰ级 ,生活、工作正常。结论　 4℃Stanford液灌注保存 ,术中去白细胞氧合温血灌注供心保护效果好。Objective To summarize the protection method of donor heart undergoing orthotopic heart transplantation. Methods The donor heart were arrested with aorta perfusion using Stanford solution in 4℃, and preserved in ice saltwater. Two donor heart were perfused with 500mL Stanford solution at aorta when donor hearts was clipped, interval or continuous oxygenous blood cardioplegia perfasion with leukocyte depletion at 24～30℃.Results One donor heart recover beating spontaneously and two donor heart recover beating by defibrillator at 20WS after removal of the aortic cross clamp, the continual monitoring of cardic output and echocardiography showed satisfactory during operation and postoperative period. The postoperative follow up in short term showed life quality well with stage 1 NYHA heart function. Conclusion It is appropriate to donor heart protection in heart transplantation by using Stanford solution in 4℃and oxygenous blood cardioplegia undergoing leukocyte depletion.

关 键 词：体外循环 心脏移植 供心保护 同种原位移植 

分 类 号：R654.2[医药卫生—外科学]