人工心脏的并发症及处理

Complications and Management after Artificial Heart Implantation

目的 探讨人工心脏应用过程中的并发症及防治办法。方法 2 0 0 1年 1月— 2 0 0 1年 9月共有 4例病人行人工心脏植入术。其中终末期扩张性心肌病合并心衰 2例 ,肥厚性心肌病心跳骤停 1例 ,急性广泛心肌梗死心源性休克 1例。术前心功能均为Ⅵ级。全部病人中有 3例为左心辅助 ;1例为双心室辅助。结果 本组所有病人术后心功能均得到明显恢复。 2例于术后心功能基本恢复并成功拆除人工心脏。并发症 :术后早期胸腔引流量 2 0 0～ 45 0ml,晚期出血 1例 ;脑栓塞 1例 ,血泵内血栓形成 3例 /次 ;右心功能不全 1例 ,所有病人术后均未发生切口感染 ,死亡 1例。结论 人工心脏可以明显促进心衰病人心功能的恢复 ,改善生活质量。加强围术期观察及处理 ,可减少并发症发生。

Objective To discuss the complications and management after artificial heart implantation.Methods From January to August 2001, 4 patients were implanted artificial heart (VAD). Among them, 2 had dilated cadiomyopathy; one had hypertrophic cadiomyopathy and cardiac arrest; one with acute myocardial infarction. 3 patients were implanted LVAD, and the other, DVAD.Results Cardiac function was improved significccantly after VAD. One patient died 10 days after implantation from multi organ dysfunctions. Two weaned from CAD successfully. Complications such as early bleeding 200～450 ml, late bleeding (1 case ); thromboembolism (1case); and right heart failure (1 case) were found, and thrombisis in VAD having 3 times.Conclusion Artificial heart can improve cardiac functions and the quality of life. To reduce the complications, management of perioperation should be strengthened.