摘要
目的总结心脏移植治疗终末期冠心病的体会。方法共有5例患者,1例为2次急性心肌梗死后行左心辅助泵植入术后25个月的患者,3例为急性心肌梗死后大面积无存活心肌、出现心力衰竭的患者,1例为经皮冠状动脉支架置入术和冠状动脉旁路移植术后仍反复发生心力衰竭的患者。均施行标准式原位心脏移植术。术前使用达利珠单抗诱导治疗1次,术后采用环孢素A、霉酚酸酯和泼尼松预防急性排斥反应。结果5例患者均痊愈出院,恢复正常的生活和工作,心功能均恢复至Ⅰ级;术后未发生严重的感染和急性排斥反应。结论心脏移植可作为治疗不适宜施行冠状动脉旁路移植术,或冠状动脉旁路移植术后效果较差的终末期冠心病患者的有效手段;选择合适的供心、良好的心肌保护、合理的抗排斥治疗方案,以及围手术期血压、血糖、血清胆固醇、尿酸的有效控制,是手术成功的关键。
Objective To summarize the early effect of orthotopic heart transplantation for 5 patients with end-staged coronary heart disease. Methods Orthotopic heart transplantations were performed on 1 patient with left ventricular mechanic circulatory support for 25 months after twice acute myocardial infarction, 3 patients with failing heart after acute myocardial infarction, 1 patient with failing heart after PTCA and CAIn. Results Five patients recovered well. No any severe acute rejection and infection have been found. All survivors had good life quality and good heart function （NYHA Ⅰ）. Conclusion Orthotopic heart transplantation is an effective treatment for patients with end-staged coronary heart disease. Proper donor heart, excellent donor myocardial conservation, suitable immurosuppression treatment and appropriate control of hypertension, hyperglycemia, hypercholesterolemia and uricacidemia are key measures of successful orthotopic heart transplantation for patients with endstaged coronary heart disease.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2005年第9期554-557,共4页
Chinese Journal of Organ Transplantation
