国内首例自制叶轮血泵作双心室辅助的临床试用

The First Clinical Trial of Impeller Blood Pumps as Biventricular Assist Device in China

目的为抢救１名法洛三联症及术后低心排血量患者，将研制的离心型人工心脏叶轮血泵首次应用于临床。方法应用叶轮血泵行双心室辅助，左泵从左心房输送血液至主动脉，右泵从右心房输送血液至肺动脉。结果血泵工作４３小时，运行正常，患者心功能得到一定程度的恢复，主动脉平均压几次达到１０．６７ｋＰａ（８０ｍｍＨｇ），但因肾功能衰竭出现水肿，最终中止抢救拆除人工心脏泵。结论患者未能存活的原因有人工心脏使用不及时，生命体征好转后过早尝试降低辅助流量，以及使用升压药导致肾血流量灌注减小等。

Objective Recently, the author's impeller blood pumps were applied as a biventricular assist device to rescue a 6 years old boy with low output syndrome after open heart surgery. Methods The left pump delivered blood from left atrium to aorta and the right pump from right atrium to pulmonary main arteria. Results In 43 hours of biventricular assistant, the patient's heart function had remarkably recovered but the renal function had gradually failed. The rescue ceased and the patient died immediately because oedema was obviously developed and surviving was hopeless. Conclusion The cause of renal failure may be:Delaying of inserting assist pumps,early attempting to wean from the blood pumps,reducing of the renal arterial perfusion by vasocontractors.