心脏移植的供心选择

20世纪80年代，环孢霉素A等免疫抑制剂广泛运用于心脏移植，心脏移植的效果显著提高，心脏移植迅速发展。在左心辅助系统等人工心脏进一步发展并能取代心脏移植之前，心脏移植已经成为终末期心脏病患者最好的选择。到目前为止，全世界已经进行了近65000例原位心脏移植术，目前每年约有3200例。     

冠心病心力衰竭与风心病心力衰竭的远期预后比较

[目的]分析比较冠心病心力衰竭与风心病心力衰竭患者的远期疗效,探讨病因对患者预后的影响.[方法]选择本院收治的101例冠心病心力衰竭患者和71例风心病心力衰竭患者,根据病因将患者分为冠心病组与风心病组,比较两组患者的临床特点和远期预后.[结果]冠心病组患者的病死率(46.53％)高于风心病组患者(16.90％),冠心病组患者的不完全恢复率(8.91％)低于风心病组患者(23.94％),且两组相比较差异均有显著性(P ＜0.05).[结论]冠心病导致心力衰竭患者的预后差,病因应作为影响因素纳入到对心力衰竭患者预后的评价中.     

心脏不停跳下先心纠治术的临床分析

目的：探讨心脏不停跳下房室缺修补手术的优点，为心内直视房室缺修补手术提供一种安全可靠的方法。方法：106例房室缺患者，在体外循环心脏不停跳下行心内直视手术。其中室间隔缺损64例，房间隔缺损42例。结果：本组病例术中经过顺利，未出现室颤及空气栓塞。术后无神经系统并发症，于术后10-14d痊愈出院。结论：由于该方法不阻断升主动脉，保持冠状动脉持续血液供应，避免了主动脉阻断造成的心肌缺血缺氧性损害和再灌注损伤，对心肌和神经元保护有利。     

Heart transplantation

Cardiac transplantation remains a life-prolonging process. Survival after heart transplantation has improved despite a sicker incoming patient population. The field of heart transplantation is constantly evolving. Advances in organ preservation, immune monitoring, and improved immunosuppressive regimens will continue to develop over time. The impact of the newest immunosuppressive agents and protocols, improved diagnostic testing, and new management strategies is yet to be determined. The potential of cell therapy is still under evaluation and the field is still in its infancy but rapidly evolving; the key to the future in this field may not be the delivery of the cells themselves but understanding how they interact with one another at a molecular level and, in particular, with resident stem cells in cardiac tissue. In addition to the medical advances, health care professionals need to educate the public about the benefits of transplantation as well.     

心力衰竭

心力衰竭(heart failure,简称心衰)是由于任何原因的初始心肌损伤(如心肌梗死、心肌病、血流动力学负荷过重、炎症等)引起心肌结构和功能的变化,最后导致心室泵血和(或)充盈功能低下.主要表现为呼吸困难、无力导致运动耐量下降,以及液体潴留导致肺淤血和外周水肿[1].     

Heart failure

Heart failure is the most common reason for hospital admission in the United States. All nurses, regardless of their specialty, should be familiar with this clinical syndrome. This column describes the pathophysiology and treatment of heart failure.     

Heart transplantation

Although the clinical outcome of heart transplantation in Japan is excellent in the past 11 years after establishment of the Organ Transplant Law, the total number of heart transplant is extremely limited in Japan, only 69 cases. The Law was revised and enforced in July 17, 2010, and pediatric heart transplantation is authorized in Japan from the legal point of view under the revised law. The most important revision of the law is that organs can be donated from brain death cadavers without written declaration of the donors themselves. We expect the number of the heart transplantation will be increased up to 30 to 50 cases per year, and social conditions are required also to be revised according to the revision of the Organ Transplant Law.