10例同种异体原位心脏移植的术后近期处理经验

Postoperative management of orthotopic homologous heart transplantation in ten cases

目的 总结 10例同种异体原位心脏移植的术后近期处理经验 ,着重探讨术后近期的抗排斥治疗、常见并发症的处理等问题。方法 2 0 0 0年 5月至 2 0 0 1年 4月共施行了 10例同种异体原位心脏移植手术 ,术后分别采用了两种免疫抑制治疗方案。 6例用环孢素A +霉酚酸酯 +强的松 ;4例用他克莫司 (FK5 0 6 ) +霉酚酸酯 +强的松。结果 10例病人均于术后 1个月左右康复出院 ,心功能状况及生活质量良好。其中 2例术后 1周出现一过性糖尿病 ,1例出院 1个月恢复工作后出现肺部感染 ,经治疗后均痊愈。结论 同种异体原位心脏移植手术后 ,合理应用免疫抑制剂 ,积极、正确处理并发症 ,能使病人早日康复 。

Objective: To review the experience of postoperative management of orthotopic homologous heart transplantation in ten cases, and to discuss some questions such as immunosuppressive therapy and the treatment of some complcations. Methods: Orthotopic homologous heart transplantation was performed on ten cases during May 2000 to April 2001. Postoperative immunosuppressive therapy was applied including cyclosporine+mycophenolate mofeti+prednisone in 6 cases and tacrolimus+mycophenolate mofeti+prednisone in 4 cases. Results: Ten patients were discharged about 40 days after heart transplantation. Their heart functions are normal after follow up for one to twelve months. During the period of follow up,two patients devoloped post transplantation diabetic mellitus, and post transplantation pulmonary infection was found in one case. All of them recovered successfully. Conclusion: Proper postoperative managements are important factors for the smooth recovery at the early postoperative stage, and are strongly associated with survival rate of patients following heart transplantation.