原位心脏移植术后早期血流动力学监测及护理

Early hemodynamics monitoring and nursing care after orthotopic heart transplantation

目的 探讨原位心脏移植术后血流动力学的监测与护理,以指导临床治疗,提高早期存活率.方法 总结96例晚期心脏病患者接受同种异体原位心脏移植临床资料,术后早期对其血流动力学指标进行监测和护理,维持血流动力学稳定.结果 所有病人术后均接受血管活性药物治疗,移植早期7例患者因移植心脏急性右心功能不全而死亡,89例患者康复出院.结论 原位心脏移植术后血流动力学变化多发生在早期,主要为右心功能不全所致,及时监测血流动力学变化并分析其原因,可以正确指导临床治疗,对病情恢复及愈后起着重要作用.

Objective To explore the experience of monitoring and the nursing care of early hemodynamics after orthotopic heart transplantation in order to improve the short-term outcome. Methods A total of 96 patients with end-stage cardiopathy underwent orthotopic heart transplantation. The hemodynamic were closely monitored and nursed care after operation in order to maintain the stability of hemodynamics of allografts. Results All recipients received vasoactive drug therapy and seven recipients died of acute allograft right ventricle dysfunction during the postoperative period. The rest survived well and had a rather good quality of life. Conclusions The hemodynamic changes often occur at the early term after orthotopic heart transplantation. The main change is the right ventrieular failure. It is important for the recovery and prognosis to monitor the hemodynamic changes and analyze the cauls in order to direct the therapy.