原位心脏移植的围术期处理

Peri-operative management in orthotopic heart transplantation

目的总结3例原位心脏移植成功患者的围术期处理经验。方法2001年8月至2003年12月为3例终末期心脏病患者施行原位心脏移植术,术式均采用双腔静脉吻合法,术后采用环孢素A、泼尼松及吗替麦考酚酯联合免疫抑制治疗。结果3例患者均顺利出院,心功能恢复至Ⅰ-Ⅱ级(NYHA),围术期无感染或严重排异反应发生。结论正确的围术期处理是心脏移植术后早期顺利康复的关键。

Objective To present the experience in perioperative management of orthotopic heart transplantation in three cases. Methods From Aug 2001 to Dec 2003, three patients with end-stage heart disease were underwent orthotopic heart transplantation. The tecnique of operations were orthotopic bicaval heart transplantation under extracorporeal circulation. Postoperative immunosuppressive therapy were applied with cyclosporine A plus prednisone and mycopenolate mofetil. Results Three patients were well recovered and discharged without acute rejection or infection, heart function recovered to class Ⅰ - Ⅱ （NYHA）. Conclusion Suitable peri-operative management are important factors for the smooth recovery at the early postoperative stage.