左心室辅助装置植入术的体外循环管理  

The experience of cardiopulmonary bypass management of left ventricular assist device surgery

作　　者：王建 高国栋 袁媛 闫姝洁 刘刚 高思哲 闫伟东 王靖 张寒 王添隆 吉冰洋 Wang Jian;Gao Guodong;Yuan Yuan;Yan Shujie;Liu Gang;Gao Sizhe;Yan Weidong;Wang Jing;Zhang Han;Wang Tianlong;Ji Bingyang(Department of Cardiopulmonary Bypass,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)

机构地区：[1]中国医学科学院阜外医院体外循环科,北京100037

出　　处：《中国体外循环杂志》2024年第3期171-176,共6页Chinese Journal of Extracorporeal Circulation

基　　金：中国医学科学院临床与转化医学研究基金(2020-I2M-C&T-B-054)。

摘　　要：目的总结左心室辅助装置植入术的体外循环管理经验。方法回顾性分析2017.6~2021.12阜外医院心外科实施的42例左心室辅助装置植入术的体外循环管理方法和经验。结果42例患者进行体外循环下左心室辅助装置植入手术治疗,均顺利脱离体外循环辅助。其中37例患者带泵生存,2例患者心脏移植,1例患者心功能好转撤除左心室辅助装置,1例患者因肺部感染死亡,1例患者因多脏器功能衰竭死亡。结论左心室辅助装置植入术患者多为长期慢性心力衰竭患者,应通过改良预充方案、心肌保护、控制超滤量、优化容量管理、调节流量与心室辅助装置相适应以改善患者预后。Objective To summarize the experience of cardiopulmonary bypass management of left ventricular assist device surgery in order to improve the prognosis of patients.Methods Retrospective analysis of the management points and clinical data of 42 cases of left ventricular assist device implantation performed in the Department of Cardiology,Fuwai Hospital,2017.6-2021.12 were conducted.Results 42 patients underwent left ventricular assist device insertion surgery,and all of them were successfully removed from the extracorporeal circulation assist.Among them,37 patients survived with pumps,2 patients had heart transplantation,1 patient had improved heart function and removed LVAD,1 patient died of lung infection and 1 patient died of multiple organ failure.Conclusion Most patients with LVAD have long-term chronic heart failure.Modified preflushing scheme,controlled ultrafiltration volume,optimized volume management,and adjusted flow rate are compatible with ventricular assist devices to improve patient prognosis.

关 键 词：终末期心力衰竭 左心室辅助装置 心肺转流管理 

分 类 号：R654.1[医药卫生—外科学]