左心辅助泵在心脏术后严重心力衰竭患者中的应用  

The Experience of Application Left Ventricle Assist Devices in Postoperative Severe Heart Failure

作　　者：王维俊[1] 池浩[1] 周嘉[1] 葛云霞[1] 冯缘[1] 陈长志[1] 薛松[1] 

机构地区：[1]上海交通大学附属仁济医院心胸外科,上海200127

出　　处：《中国体外循环杂志》2006年第3期152-155,共4页Chinese Journal of Extracorporeal Circulation

摘　　要：目的 总结在心脏术后发生严重心力衰竭患者中应用左心辅助泵（LVAD）的经验。方法 收集8例心脏术后发生严重心力衰竭患者中应用左心辅助泵（转子泵和离心泵各4例）的临床资料。结果 8例患者中6例脱机，3例存活出院，脱机率和出院率分别为75％和37．5％。辅助流量27～67（43）ml／（min·kg），出院患者平均辅助流量为55ml／（min·kg）。辅助时间2．5～50（28）h。主要并发症为出血、多脏器功能衰竭（MOF）、肾功能衰竭、室性心律失常、感染等。死亡原因为MOF、肾功能衰竭、恶性室性心律失常及出血。结论 离心泵和转子泵用于术后短期辅助中均取得满意结果，及时进行有效的左心辅助并积极防治并发症是成功进行左心辅助的关键。OBJECTIVE To analyze clinical application of left ventricle assist devices （LVAD） in salvaging postoperative severe heart failure. METHODS From December 1994 to July 2005, LVAD was used in 8 patients who had severe postoperative heart failure. RESULTS Six of 8 patients were successfully weaned off LVAD（75% ）, and three（37.5% ） were discharged. The duration of assist ranged from 2.5 to 50 hours（mean 28 hours）. The flow rate of LVA was maintained at 27 to 67 ml/（min·kg） [mean 43 ml/（min ·kg） ] ,mean of that in survivors was 55 ml/（min·kg）, Major complications were bleeding, MOF, renal failure, ventricular arrhythmia, infection and so on. The causes of death were MOF, rehal failure, malignant ventricular arrhythmia and bleeding. CONCLUSION Centrifugal and roller pumps could be used as short- term LVAD with a satisfactory results. They are economical, safe and easy for manipulating. LVA should be established as early as possible in postcardiotomy severe heart failure.

关 键 词：心脏术后 心力衰竭 左心辅助 

分 类 号：R654.2[医药卫生—外科学] R541.6[医药卫生—临床医学]