摘要
目的：探讨原位心脏移植手术的配合方法和提高手术成功率的相关因素方法：对8例患者施行原位心脏移植术，采用标准原位心脏移植手术1例，双腔静脉吻合法原位心脏移植手术7例。术前做好各项准备，术中认真配合手术结果：其中1例术后第9天出现急性排异反应，应用大剂量泼尼松龙冲击治疗3d后缓解：1例术后第3天出现肾功能衰竭，血液透析治疗20d恢复；1例术后35d死于肾功能衰竭及抗排异药物神经毒性反应；其余病例心功能恢复至Ⅰ～Ⅱ级；术后5例已恢复正常工作和生活；2例经超声心动图检查发现二尖瓣和三尖瓣轻度关闭不全结论：提高原位心脏移植患者手术成功率，除了常规方法外，充分的术前准备、密切的手术配合是手术成功的重要因素.
Objective ： To discuss the methods of nursing cooperation and relevant factors to increase the successful rate of orthotopic heart allotransplantation. Methods： The standard orthotopie heart transplantation was performed on one of the 8 patients, and the other 7 patients were treated with bieaval orthotopic heart transplantation. Preoperative preparation was fully completed and nursing cooperation was done well in operation. Results： Acute rejection occurred in one patient on the ninth day after transplantation and the symptoms eased through 3 - day pulse therapy with a large close of prednisolone; one patient suffered from renal failure on the third day after transplantation and recovered after 20 -day hemodialysis; one patient died of renal failure and neurotoxie reaction of anti - rejection drug. The heart function of the rest patients restored degree Ⅰ and degree Ⅱ. Five patients returned to normal work and life. Conclusion： For increasing the successful rate of orthotopic heart transplantation, fully preoperative preparation and close cooperation in operation is very important besides the routine methods.
关键词
原位心脏移植
同种异体
手术配合
Orthotopic heart transplantation
Allograft
Cooperation in operation
