心脏移植术后并发症13例分析报告

The postoperative complications of heart transplantation in 13 cases

目的 探讨心脏移植术后发生并发症的危险因素及处理方法。方法 对 13例终末期扩张型心肌病患者施行了同种原位心脏移植术 ,12例为改良经典式 ,1例为全心脏原位移植。结果 13例手术均顺利 ,其中 4例存活时间短于 10d ,1例存活 17周 ,其余均长期存活 ,且生活质量良好 ,心功能 0～ 1级 ;本组病例术后并发症以感染为主 ,其次为心律失常及各种原因所致的肝、肾功能损害。结论 心脏移植术后的并发症可发生在各个系统 ,术前各脏器的一般情况、手术打击、术后监护的程度及用药情况等均可影响并发症的发生。

Objectives To expore the risk factors and treatments of the cimplications following heart transplantation. Methods In our hospital from Aug. 1995 to Sep. 1999, 13 patients with end stage dilatation cardiomyopathy underwent orthotopic heart transplantion (OHT): 12 received standard style of OHT and one total style of OHT. Results The operations for 13 cases were all successful. Four of the 13 cases survived for no longer than 10 days and one survived for 17 weeks. The remaining got prolonged survival with good quality of life and various complications in different degrees after transplantation. The complications after transplantation were infection, followed by arrhythmia and liver and kidney function damage induced by various causes. Conclusions The preoperative common situation of the organs, the operative infliction, postoperative monitoring and the medicine might responsible for the post transplant complications which occured in many systems.