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作 者:肖学钧[1] 范瑞新[1] 成安衡[1] 罗征祥[1] 张镜芳[1] 吴若彬[1] 丁以群[1] 高婉梅[1] 叶椿秀[2]
机构地区:[1]广东省心血管病研究所,广州市510100 [2]上海第二医科大学附属仁济医院,上海市200001
出 处:《岭南心血管病杂志》2002年第1期43-45,共3页South China Journal of Cardiovascular Diseases
摘 要:目的 总结新型国产隔膜气动左心辅助泵 (罗叶泵 )临床试用 4例病人的经验。临床资料及结果 本组 4例病人均为心脏手术后严重低心排出量综合征病人 ,其中 1例合并围术期急性心肌梗死。 3例应用主动脉内球囊反搏(IABP)效果不满意再行左心辅助 ,1例直接行左心辅助。左心辅助时间 30 3~ 116h ,平均 78 1h。本组死亡 3例 ,1例死于肾功能衰竭 ,1例死于多脏器官功能衰竭 ,1例死于脑出血。本组存活 1例 ,左心辅助期间出现左颞叶和顶叶脑梗死 ,右侧肢体偏瘫 ,经治疗后好转出院 ,随访 6个月 ,右侧肢体活动明显改善 ,一般情况尚好。结论 新型国产隔膜气动左心辅助泵 (罗叶泵 )在抢救心脏手术后严重低心排出量综合征中显示能较满意地维持血流动力学的稳定 ,有较IABP更显著的效果。在应用时要把握时机 ,尽早应用。然而 ,左心辅助的应用仍存在安置较为复杂 ,易渗血等不足之处 ,有待今后进一步总结经验 ,加以改进 。Objective To review the experiences in 4 patients who received pneumatic left ventricular assist pump (Luo-Ye pump). Clinical materials and results The 4 patients all had severe low cardiac output syndrome after open heart surgery, one of them associated perioperative acute myocardial infarction. Three patients performed left ventricular assist device (LVAD) after intra aortic balloon counterpulsation (IABP); One patient performed LVAD directly. Mean LVAD support time was 78 1 hours, range from 30 3 to 116 hours. Three patients died, the causes of death included renal failure ( n= 1 ), multiple organ failure ( n= 1) and intracerebral hemorrhage ( n= 1). One survival patient suffered from left temporal lobe and left parietel lobe cerebral infarction with right hemiparalysis. The patient discharged after treatment and has been followed-up 6 months. The right thoracic and pelvic limb function improved significantly and in good condition. Conclusion The result of clinical trial of Lou-Ye pump in rescuing severe low cardiac output syndrome postcardiotomy showed that the pneumatic pump is more effective in comparison to IABP in maintain the hemodynamic. We consider that LVAD should be used as early as possible to get the best result, and we found there were problems in application of Luo-Ye pump during the assist period, for example, sophisticated installation and easily bleeding. We should summarize experiences and improve the device to make LVAD use more broadly in our country.
关 键 词:左心辅助装置 国产隔膜气动泵 临床试用 低心排出量综合征 心脏手术
分 类 号:R318.1[医药卫生—生物医学工程]
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