CAJ | 학술논문

目的总结3例心脏移植的初步经验.方法 3例扩张性心肌患者进行了双腔静脉法的同种原位心脏移植,围手术期间给予受体的维护、供心离体时间长的保护、血流动力学的支持、抗排异反应及感染方面的处理.结果 3例患者均存活,心功能由Ⅳ级提高到Ⅰ、Ⅱ级,分别随访19、28、49个月,2例因未正常服药发生排异反应.结论选择合适的供体和受体、良好的供心保护技术、有效的血流动力学支持、抗排异反应方案得当、防止感染是围手术期处理的重要组成部分,是手术成功的关键.正规服用抗排异药物是避免或减少排异反应的基本条件.
목적 총결3례심장이식적초보경험.방법 3례확장성심기환자진행료쌍강정맥법적동충원위심장이식,위수술기간급여수체적유호、공심리체시간장적보호、혈류동역학적지지、항배이반응급감염방면적처리.결과 3례환자균존활,심공능유Ⅳ급제고도Ⅰ、Ⅱ급,분별수방19、28、49개월,2례인미정상복약발생배이반응.결론 선택합괄적공체화수체、량호적공심보호기술、유효적혈류동역학지지、항배이반응방안득당、방지감염시위수술기처리적중요조성부분,시수술성공적관건.정규복용항배이약물시피면혹감소배이반응적기본조건.
Objective To share the experience of heart thransplantation. Methods 3 recipients with terminal myocardiosis were reviewed. The transplantation was performed with inferior and superior vena anastomofic technique. During perioperative period, we selected and maintained the recipients, protected donor-isolated heart, supported circulation,decreased immune reaction and controlled infections. Results All the 3 patients survived. Heart function improved from NYHA class 1V before heart transplant to NYHA class Ⅰ, Ⅱ. The follow-up time was 19 months ,28 months and 49 months respectively. Rejection occurred in two cases due to non-compliance to medication. Conclusions Suitable recipient, proper donor heart procurement and preservation, suitable maintenance of circulation, proper managements of anti-immunitive reaction, prevention of infections are critical for successfal heart transplantation. Medicine-take required may avoid or reduce rejection.