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目的:观察心室辅助(VAD)、体外膜式氧合(ECMO)及主动脉内气囊反搏(IABP)等机械循环辅助装置治疗围手术期急性心肺功能衰竭的疗效。方法:回顾2005年1月至2006年12月我院心脏外科监护病房224例围手术期进行循环辅助患者临床资料,VAD4例、ECMO47例及IABP173例。结果:VAD死亡2例(50%),ECMO死亡23例(48.9%),IABP死亡49例(28.3%)。并发症为感染27例、肾功能衰竭需要透析26例、出血23例、下肢缺血15例及脑并发症7例。结论:机械辅助是救治围手术期急性心肺功能衰竭的有效方法,应根据患者病情选择适合的辅助方式并及早放置,防治并发症对提高成功率非常重要。
OBJECTIVE: To observe the curative effect of perioperative acute cardiopulmonary failure by mechanical circulation assisting devices such as ventricular assist (VAD), extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP). Methods: From January 2005 to December 2006, 224 patients with cardiac surgery in our hospital were enrolled in this study. Clinical data of 224 patients with VAD, 4 VAD, 47 ECMO and 173 IABP were retrospectively analyzed. Results: Two patients died of VAD (50%), 23 patients died of ECMO (48.9%) and 49 patients died of IABP (28.3%). The complications were infection in 27 cases, renal failure in need of dialysis in 26 cases, hemorrhage in 23 cases, lower extremity ischemia in 15 cases and brain complications in 7 cases. Conclusion: Mechanical assistance is an effective method to treat acute cardiopulmonary failure in perioperative period. It is very important to select suitable adjunct and place as soon as possible according to the patient’s condition. Prevention and treatment of complications is very important to improve the success rate.