亚太地区首二例Algisyl可植入性水凝胶治疗心力衰竭  

First implantable hydrogel Algisyl for treatment of heart failure in Asia-Pacific region

作　　者：刘先宝[1] 董爱强[2] 孔敏坚[2] 杨倩[3] 何伟[4] 谢小洁[1] 樊友启[1] 蒋巨波 汤梦瑶 何宇欣[1] 严敏[4] 王建安[1] 

机构地区：[1]浙江大学医学院附属第二医院心血管内科,杭州310009 [2]浙江大学医学院附属第二医院心脏大血管外科,杭州310009 [3]浙江大学医学院附属第二医院超声科,杭州310009 [4]浙江大学医学院附属第二医院麻醉科,杭州310009

出　　处：《中华急诊医学杂志》2015年第6期594-596,共3页Chinese Journal of Emergency Medicine

摘　　要：目的探讨Algisyl可植入性水凝胶在心力衰竭中的运用及注意事项。方法回顾性分析2015年4月浙江大学医学院附属第二医院心脏中心开展2例Algisyl可植入性水凝胶治疗心力衰竭的手术过程与患者预后情况，并对术前评估、术中操作以及患者术后情况进行总结。结果2例患者严格进行术前评估；术中行全身麻醉、气管插管；由心脏大血管外科医生实施左侧肋间切口，暴露心脏；确认患者的左心室中间水平为注射部位，每个注射点注射0．3 mL Algisyl，注射点间距1．5cm左右（总注射针数取决于患者心脏大小，一般14-19点）。术中患者未发现持续性室速、室颤等恶性心律失常现象，无心脏骤停、过敏、栓塞等不良事件。术后患者胸闷气急等症状明显缓解，恢复良好，顺利出院。手术首次采用斜行进针和实时超声监控的方法，避免Agisyl进入血液，提高手术的安全性。结论Algisyl可植入性水凝胶在心力衰竭中的运用是安全可行的，患者的远期预后还有待进一步观察。Objective To explore the performance of the implantable hydrogel Algisyl in the treatment of heart failure. Methods Two patients with heart failure underwent Algisyl treatment at the Second Affiliated Hospital of Zhejiang University School of Medicine, were retrospectively analyzed for the process of procedure and patients＂ prognosis. Preoperative assessment, procedural process and the postoperative recovery were summarized. Results Two patients were assessed before operation carefully according to the inclusion criteria. General anesthesia and intubation were performed during the procedure. Hearts were exposed by cardiac surgeons, followed by confirmation of injection site at intermediate level of the left ventricle. Up to 0.3 mL Algisyl was injected in each injection point （total number of injection points depends on the patiehLs heart size, generally 14 to 19 points） at the space of 1.5 cm between injections. No adverse events such as sustained ventricular tachycardia, ventricular fibrillation and other malignant arrhythmia, cardiac arrest, allergy, thrombosis were found. Patients＇chest tightness, shortness of breath and other symptoms were significantly relieved after the operation. Oblique injection and real-time ultrasonic monitoring were first adopted to avoid Algisyl entering the blood and improve the safety of surgery. Conclusions It is feasible and safe using Algisyl implantable hydrogel to treat heart failure, while follow - up is necessary for the evaluation of long - term prognosis.

关 键 词：心力衰竭 扩张型心肌病 可植入性水凝胶 Algisyl 

分 类 号：R541.6[医药卫生—心血管疾病]