冠状动脉旁路移植术后左心辅助临床应用体会  

Clinical use of left ventricular assist in coronary artery surgery

作　　者：李京倖[1] 朱晓东 胡盛寿 

机构地区：[1]中国医学科学院协和医科大学心血管疾病研究所阜外心血管病医院心外科

出　　处：《中华胸心血管外科杂志》2003年第1期33-35,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　总结冠状动脉移植术 (搭桥术 )后使用左心机械辅助情况 ,为临床处理重症冠心病提供参考。方法　回顾分析了 170 4例搭桥术病人使用左心辅助的情况 ,并分析了其与并发症、病死率相关因素。结果　搭桥术病人左心机械辅助使用率为 1 5 % ,脱机率 76 % ,出院率 48%。主要并发症为多发性器官功能衰竭 (MOF)、出血等。死亡病人大多在脱机后发生 ,主要死因为MOF、肾功能不全、心功能衰竭。结论　搭桥术后左心机械辅助应强调早期使用 ,如有可能 ,小流量观察一段时间再停机。Objective: To review the experience of using left ventricular assist(LVAD) in coronary artery bypass grafting (CABG). Methods: The data of 1?704 CABG cases were analyzed. 25 patients required LVAD after CABG (1.5%, 25/1?704). Results: About 78% of 25 patients were weaned off LVAD, and 48% of them were discharged. IABP was used in 88% of patients. The major complications were MOF, lung disease, renal insufficiency/failure, arrhythmia, coagulopathy, and infection. The causes of death were MOF, pump failure, renal failure, ventricular fibrillation, respiratory failure, bleeding. Conclusion: LVAD is a very useful tool in salvaging left ventricular failure. LVAD should be used as early as possible. Before weaning, trials should be madeat decreasing flow rates.

关 键 词：临床应用 冠状动脉疾病 冠状动脉分流术 心脏辅助装置 冠心病 

分 类 号：R654.2[医药卫生—外科学]