BVS5000左心辅助装置在心力衰竭患者中的临床应用体会  

Clinical experience of BVS5000 left ventricular assist devices in heart failure patients

作　　者：胡盛寿[1] 孙寒松[1] 罗新锦[1] 刘平[1] 张岩[1] 马维国[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院心外科,北京100037

出　　处：《中华外科杂志》2008年第7期531-533,共3页Chinese Journal of Surgery

摘　　要：目的总结运用BVS5000左心室机械辅助装置救治重症心力衰竭患者的临床经验。方法2004年2月至2006年4月应用BVS5000左心室机械辅助装置治疗12例男性患者。年龄（55．2±9．6）（39～68）岁，体表面积（1．76±0．1）（1．6～1．9）m^2。11例为心脏术后患者（92％），1例为扩张性心肌病急性心功能不全患者。7例患者采用了改良的经房间沟-股动脉置管法，于局麻下撤除辅助装置，未二次开胸。结果全组平均左心室辅助（8．8±11．2）（3～43）d，辅助流量3．8～4．5L／min。9例患者（75％）成功脱离辅助，8例患者（67％）恢复出院。4例患者（33％）死亡；主要致死原因是神经系统并发症。常规置管组（5例）与改良法置管组在辅助时间、辅助流量、呼吸机辅助及重症监护治疗病房停留时间等方面无差异。结论BVS5000左心室辅助装置是一种有效的短期机械循环辅助装置。采用改良置管方法可以简化撤机操作。Objective To explore the experience of Abiomed BVS5000 as a mean of left ventricular support on clinical treatment for severe heart failure patients. Methods From February 2004 to April 2006, 12 male patients were supported with Abiomed BVS5000 as a left ventricular assist device. The average age was （ 55.2 ± 9. 6） years old （ range from 39 to 68 years old）. Mean body surface area was （ 1.76 ± 0. 1 ） m^2 （ range from 1.6 to 1.9 m^2 ）. Devices were inserted for post-cardiotomy shock after coronary artery bypass grafting in 11 patients （92%） and in 1 dilated cardiomyopathy patient for acute cardiogenic shock. Modified cannulation methods by inserting the arterial cannulae in femoral artery and inserting the venous cannual in left atrial through bovine jugular vein were used in 7 patients. In this way, the device could be taken off without resternotomy when support was finished. A comparison was made between the modified method and routine left atrium-to-ascending aorta cannulating method. Results The average duration of support was （ 8.8 ± 11.2 ） d （ range from 3 to 43 d） , with support flow rate of 3. 8 to 4. 5 L/min. There were 9 patients （75%） weaned from support and 8 patients （67%） discharged from the hospital. Four patients （33%） were dead. The most common morbidity was adversed neurologic events. There was no statistic difference between modified and routine method on average BVS5000 support duration, assisted flow rate, mechanical ventilation duration, stay of intensive care unit and thoracic drainage. Conclusions The Abiomed BVS5000 is valuable to support patients with acute cardiogenic shock for short-term use. With using modified cannulating method, the weaning procedure can be effectively simplified.

关 键 词：心力衰竭 充血性 心转流术 左 心脏外科手术 

分 类 号：R686[医药卫生—骨科学]