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机械循环辅助在心源性休克的救治中起着日益重要的作用,可纠正患者的血流动力学紊乱状态,保障再灌注治疗的实施。其中主动脉内球囊反搏最常用也最为成熟;心室辅助装置在逆转休克的血流动力学和代谢参数方面优于标准主动脉内球囊反搏治疗,近年来,经皮左室辅助装置逐渐应用于临床,其创伤小且无需体外循环,是今后的发展方向;目前体外膜氧合器多用在爆发性心肌炎或心脏外科术后支持,其应用于急性心肌梗死并发心源性休克治疗的证据不足,有待于更大规模的临床研究验证。未来循环辅助装置的发展方向是体积小、微创、植入和撤除方便、组织相容性好、辅助效果确切。
Mechanical circulatory support plays an increasingly important role in the treatment of cardiogenic shock, can correct the patient’s hemodynamic disorders and protect the implementation of reperfusion therapy. Among them, aortic balloon pump is the most commonly used and the most mature; ventricular assist device in the reversal of shock hemodynamics and metabolic parameters than standard aortic balloon pump therapy, in recent years, percutaneous left ventricular assist device Gradually applied to clinical, and its trauma is small and without cardiopulmonary bypass, is the future direction of development; present in vitro membrane oxygenator is often used in patients with fulminant myocarditis or cardiac surgery after surgery, its application in acute myocardial infarction complicated by cardiogenic shock treatment Insufficient evidence to be confirmed in a larger clinical trial. The future direction of the development of circular auxiliary device is small, minimally invasive, easy implantation and removal, good tissue compatibility, assistive effect is accurate.