八例心脏移植和一例心肺联合移植术后近期并发症的防治

目的探讨8例心脏移植和1例心肺联合移植术后近期并发症的预防和治疗。方法2004年5月至2006年2月，对8例患者进行了同种原位心脏移植术，1例患者进行了同种原位心肺联合移植术。术后密切观察并及时处理患者的近期并发症。结果9例患者中，1例术后近期出现高血压；1例发生心功能不全；2例发生巨细胞病毒感染；心肺联合移植的患者出现。肾功能不全、气管吻合口狭窄和霉菌感染。经调整免疫抑制剂及对症、支持等处理后，所有患者症状均缓解。结论重视围手术期的处理和选择合理的抗排斥反应治疗方案，正确处理术后并发症，可降低患者移植术后死亡率，获得满意的早期疗效。

Prevention and treatment of short-term complications in 8 heart transplantations and 1 heart lung transplantation

Objective To summary the experience of management for orthotopic homologous heart transplantation, heart-lung co-transplantation and to discuss the postoperative treatment of short-term complications. Methods Orthotopic homologous heart transplantation and heart-lung cotransplantation on 9 cases were performed from May 2004 to February 2006. The patients were traced closely and all complications were treated in time. Results During hospital stay, hypertension occurred in one case, right heart insufficiency in one case, infection of mycetes and cytomegalovirus in 2 cases after the heart transplantation, and in the patient undergoing heart-lung co-transplantation, renal inadequacy, bronchial anastomosis stenosis and fungus infection occurred. All patients obtained symptomatic relief before discharge. Conclusion Proper perioperative management, imrnunosuppressive therapy and management of postoperative complications could reduce mortality and obtain satisfactory therapeutic effect in the near future.