心脏移植术后急性排斥反应的监测

笔者总结3例心脏移植术后急性排斥反应的监测与护理。监测临床症状和体征、12导联心电图、超声心动图、外周血T淋巴细胞、X线影像．心内膜心肌活枪(EMB)等指标，发现1a级排斥反应3次．2级排斥反应1次。认为EMB是目前诊断心脏移植急性排斥反应最为可靠的敏感指标：超声心动图为诊断急性排斥反应的重要手段，可及时无创地监测排斥反应，为调整免疫抑制剂的剂量、适时合理地行EMB提供重要的参考依据：其它指标有助于全面了解患者情况：仔细观察、综合分析病情，能有效地减少有创性心肌活检的次数。

Monitoring of acute rejection after heart transplantation

The author summarized monitoring of 3 cases with acute rejection after heart transplantation and their nursing. 1a degree rejection was found for 3 times and 2a degree rejection was found for 1 time by monitoring index such as clinical symptom and life signs, 12 cardiograph, echocardiogram, peripheral T cell, X ray image, EMB and so on. The author held EMB is the most sensitive index to diagnose acute rejection after heart transplantation at present. Echocardiogram is a key way to diagnose acute rejection, can monitor rejection with no wound timely, and provides important basis for adjusting dose of immunosuppression and applying EMB properly and timely. Other index can help to understand patients' situation comprehensively. Careful observation and comprehensive analysis of disease can effectively reduce times of EMB.