辅助循环在心脏围手术期应用的临床实践

Clinical practice of mechanical circulatory support after cardiac surgery

目的 回顾性总结 11例心脏围手术期患者施行辅助循环的经验。方法 左心辅助 2例、右心辅助1例、双心辅助 3例、体外膜肺氧合 1例、左心辅助 +主动脉内球囊反搏 (IABP) 3例、单纯 IABP1例。辅助时间 3～135 h,平均 (2 4 .4± 37.3) h。结果 全组患者在应用辅助循环早期循环功能均有改善 ,5例脱离辅助循环 ,4例存活出院。死亡原因为顽固性不可逆心衰、多脏器功能衰竭、出血等。结论 及早地应用辅助循环并加强辅助循环中的维持和处理 ,严密监测 ,将副作用减低到最小程度 。

Objective To review the experience of peri operative management of open heart surgery with mechanical circulatory support.Methods Mechanical circulatory support were used in 11 patients who could not be weaned from cardiopulmonary bypass(CPB)or developed heart failure after removal from CPB.The duration of the mechanical assist ranged from 3 to 135 mean(24.4±37.3)hrs.Results Five patients were weaned from mechanical support,4 patients were discharged.All patients had improved hemodynamic paramters when started mechanical suppt.The causes of death were intractable heart failure,muiffiorgan failure and bleeding,etc.Conclusion That factors related to the succesful recovery are the early employment of the assisted device and the efficient management during assisted circulation.