摘要
目的总结心脏移植中供心的心肌保护技术,分析供心的灌注、保存以及缺血时间对心脏移植效果的影响。方法回顾性分析2004年6月至2006年9月间的69例晚期心脏病患者行心脏移植术的临床资料。供心的心肌保护采用低温St.Thomas液和HTK液顺序灌注方法,术中供心保持持续低温状态。根据供心缺血时间长短将受者分为两组,A组36例,供心缺血时间小于240 min;B组33例,供心缺血时间大于240 min。术后对受者进行定期随访。结果在心脏移植术中,B组受者较A组的体外循环时间延长。术后两组受者的死亡率、移植心功能、排斥反应以及并发症等资料的比较,差异无统计学意义(P<0.05)。所有受者在心脏移植后,无近期死亡,但随访期间死亡6例。结论采用St.Thomas液和HTK液顺序冷灌注的改良方法,能够有效的保护供心心肌组织;供心缺血时间的缩短会使心肌泵血功能恢复较快。这些对移植心功能的恢复和受者的预后具有良好的近期和中期效果。
Objective To study preservative method of donor heart in heart transplantation and to analyze the effect of ischemic time and perfusion and preservative method of donor hearts. Methods Sixty-nine patients were subjected to heart transplantation in Fuwai Hospital from June 2004 to September 2006. The preservative method of donor hearts was sequential perfusion using cold St. Thomas and HTK solution. The patients were divided into two groups according to ischemic time of donor hearts： group A （36 cases） with ischemic time shorter than 240 min, and group B with ischemic time longer than 240 min. The patients were regularly followed up after operation. Results Ischemic time of donor hearts was from 120 min to 477 min. There was longer CPB time in group B than in group A. After operation, there were no significant differences in mortality, heart function, heart rejection, and complications between two groups. There was no death in recent period after operation, but totally 6 patients died during the period of follow-up. Conclusions Perfusion of St. Thomas and HTK solution can provide excellent preservative effect of donor hearts as well as satisfactory results of heart transplantation.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2007年第12期705-707,共3页
Chinese Journal of Organ Transplantation
关键词
心脏移植
心肌
细胞保护
器官保存液
Heart transplantation
Cardiac muscle
Cytoprotection
Organ preservation solution
