经皮心肺支持在严重心力衰竭中的临床效果：早期结果及并发症分析

Clinical effects of percutaneous cardiopulmonary support in severe heart failure: early results and analysis of complications.

作者信息

Sakamoto Shigeru, Matsubara Junichi, Matsubara Toshiaki, Nagayoshi Yasuhiro, Shono Shinji, Nishizawa Hisateru, Kanno Masaaki, Takeuchi Katsunori, Nonaka Toshimichi, Kyosawa Jun

机构信息

Department of Thoracic and Cardiovascular Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2003 Apr;9(2):105-10.

PMID:12732087

Abstract

Between January 1993 and December 2001, we employed percutaneous cardiopulmonary support (PCPS) in 35 patients. PCPS was used for postcardiotomy in 25 of these patients who could not be weaned from cardiopulmonary bypass (CPB) because of severe cardiogenic shock. In the other 10 patients, PCPS was used for a non-surgical disease. Twenty-nine patients (82.9%) were weaned from PCPS, and 28 (80.0%) survived. The other 7 patients (20.0%) died due to postoperative complications. The causes of death were multiple organ failure (MOF) due to wound bleeding, low cardiac output syndrome (LOS), myonephropathic metabolic syndrome (MNMS) with severe lower limbs ischemia, cerebrovascular accident (CVA), and sepsis. The first cause for the complications was postoperative sustained severe heart failure. To improve the survival rate, it was necessary to prevent bleeding and begin PCPS at an earlier stage.

摘要

1993年1月至2001年12月期间，我们对35例患者采用了经皮心肺支持（PCPS）。其中25例患者在心脏手术后因严重心源性休克无法脱离体外循环（CPB），遂使用PCPS。另外10例患者因非手术疾病使用PCPS。29例患者（82.9%）成功脱离PCPS，28例（80.0%）存活。其余7例患者（20.0%）因术后并发症死亡。死亡原因包括伤口出血导致的多器官功能衰竭（MOF）、低心排血量综合征（LOS）、伴有严重下肢缺血的肌病肾病代谢综合征（MNMS）、脑血管意外（CVA）和败血症。并发症的首要原因是术后持续严重心力衰竭。为提高生存率，必须预防出血并尽早开始使用PCPS。