搏动性导管泵维持急性左心衰竭的血流动力学  

Maintenance of Hemodynamics with a Pulsatile Catheter Pump in a Sheep Model of Acute Left Heart Failure

作　　者：陈长志 [1] 李智成 [1] 叶清 [1] 成少飞 [1] 王维俊 [1] 汤敏 [1] 赵晓刚 [1] Y.John Gu  

机构地区：[1]上海第二医科大学附属仁济医院,胸心外科,上海,200127 [2]荷兰Groningen大学医院,胸心外科

出　　处：《中国胸心血管外科临床杂志》2005年第3期181-184,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：中国和荷兰合作课题;受院专项基金资助~~

摘　　要：目的评估搏动性导管(pulsatilecatheter,PUCA)泵对急性心力衰竭绵羊辅助的有效性和安全性。方法对10只绵羊诱导左心衰竭模型建立成功后行PUCA泵辅助3h,监测并记录血流动力学参数,采动脉血人工计数血小板并测定血浆游离血红蛋白;经辅助3h后检查肾、隔膜泵及导管血栓形成的情况。结果10只绵羊中7只成功支持血循环达到规定的时间,另3只绵羊因技术原因未能完成实验。成功的7只绵羊在支持期间血流动力学逐步恢复并趋向稳定,血压接近基线值;血小板和血浆游离血红蛋白在辅助期间无明显变化;肾、隔膜泵及导管均未见明显的血栓形成。结论PUCA泵的短期辅助能稳定急性心力衰竭动物的血流动力学,并且无明显的血小板和红细胞破坏及血栓形成等并发症。因此,其应用安全有效,可用于临床心力衰竭患者的短期支持。Objective To assess the efficiency and safety of pulsatile catheter (PUCA) pump support during acute ischemic heart failure in sheep. Methods After heart failure model was induced successfully in 10 sheep, PUCA pump was inserted through aorta and the aortic valve orifice with its tip located in the left ventricle. It was then activated to support the hemodynamics for 3 hours. Hemodynamic parameters were monitored and recorded before thoracotomy, heart failure, and every 60 min after the support. Platelet and plasma free hemoglobin were tested during the experiment. Thrombosis in kidney, membrane-pump, and catheter were examined at the end of study. Results PUCA pump support was successful in 7 sheep for 3 hours and failed in 3 due to technical problems. During support with the PUCA pump, mean arterial pressure(MAP), systolic blood pressure (SBP) and diastolic blood pressure(DBP) increased gradually and close to the baseline at the end of experiment. No significant change in platelet and plasma free hemoglobin were found during the whole period of the PUCA pump support. No thrombosis was found as well by means of examining kidney, membrane-pump and catheter. Conclusions PUCA pump can successfully maintain the hemodynamics in a sheep acute heart failure model associated with few blood destruction and thrombosis. It is thus suitable for clinical application to heart failure patients for the maintenance of hemodynamics.

关 键 词：急性左心衰竭 搏动性 导管 血浆游离血红蛋白 急性心力衰竭 血流动力学参数 血栓形成 心力衰竭患者 红细胞破坏 血小板 人工计数 技术原因 绵羊 安全性 动脉血 血循环 并发症 隔膜 期间 短期 

分 类 号：R541.6[医药卫生—心血管疾病] R654.1[医药卫生—内科学]