联合实施心脏瓣膜置换术和肾移植术治疗心脏瓣膜病合并慢性肾功能衰竭

摘要

目的 探讨有心脏手术指征但合并肾功能衰竭的患者的手术治疗途径。 方法 为1例患有严重的风湿性心脏瓣膜病（心功能III～IV级），同时合并慢性肾功能衰竭（血尿素氮19.1mmol/L，血肌酐442μmol/L）的28岁男性患者，联合实施心脏瓣膜置换术和同种异体肾移植术，术后经过抗心衰、抗排异、纠正水电解质平衡紊乱及抗炎治疗。 结果 患者心、肾功能恢复良好（心功能I～II级，血尿素氮6.8mmol/L，血肌酐70.7μmol/L）,术后2个月出院。 结论 联合手术能够为以往因合并肾衰而不能耐受心脏手术的心脏疾病患者提供一个有效的治疗方案。%Objective To find out a proper treatment for patients who havecardiac operation indications and renal failure concomitant. Method A 28-year-old man had severe rheumatic cardiac valve disease (cardiac fonction III-IV) and chronic renal failure (ureanitrogen 19.1mmol/L, 442μmol/L). Results Combined operations of cardiac valve replacement and renal transplantation were performed. The cardiac fonction was raised to I-II, and the levels of blood ureanitrogen and creatinine were reduced to 6.8mmol/L and 70.7 μmol/L. The prognosis has been satisfying up to now. Conclusion Combined operations may be an ideal treatment for the patients with severe heart diseases and renal failure.