摘要
目的探讨肝移植术后早期缺血性心肌病的预防及治疗。方法对肝移植后早期并发缺血性心肌病的18例资料进行回顾性分析。18例均以心前区疼痛、闷胀、紧缩感为首发症状，伴有呼吸困难、出汗、心悸等症状，心电图显示ST-T段不同程度改变，同时心肌酶谱也出现不同程度的升高。确诊有心肌缺血后，用硝酸甘油扩张冠状动脉，并全部皮下注射低分子肝素抗凝。结果18例中，16例的心肌缺血缓解，术后1个月内未出现心血管不良事件；2例为心肌梗死，因术后早期仍有出血，未行溶栓及介入治疗，受者最终死亡。结论术前的仔细评估，术后早期抗凝、充分的镇痛和镇静、优化前后负荷、维持正常的红细胞压积以及血管扩张药物的应用，可降低肝移植后缺血性心肌病的发病率和死亡率。
Objective discuss the prevention and management of ischemic cardiomyopathy in the early stage after liver transplantation. Methods The clinical data of 18 patients with ischemic cardiomyopathy after liver transplantation were analyzed retrospectively. The initial symptoms of the 18 patients were precordia pain with palpitations and sweating. The electrocardiogram showed ST-T continuous changes and the myocardial enzyme increased. As soon as the diagnosis of ischemic cardiomyopathy was established, nitroglycerin, antieoagulation, and sedative treatment were provided to the patients. Results Sixteen patients recovered, and 2 developed into myocardial infarction and died. Conclusion The accurate assessment before operation, anticoagulation in the early stage, adequate sedation, optimization of the liquid load, normal hematocrit and the use of nitroglycerin are effective ways to reduce the morbidity and mortality of ischemic cardiomyopathy after liver transplantation.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2009年第1期47-49,共3页
Chinese Journal of Organ Transplantation
基金
国家自然科学基金（30671977）
首都医学发展科研基金（20052034）
