5ÔÂ26ÈÕ£¬ÓÉÎ÷°²¸ßÐÂÐÜèÌåÓýÔºÖ÷°ìµÄ¡°Í¬ÐÄͬÐУ¬¹²´´ÐÄÉú¡±¡ª¡ªÎ÷±±ÐÄË¥ÂÛ̳ÔڹųÇÎ÷°²¾ÙÐС£
±¾´Î»áÒéÓÉÎ÷°²¸ßÐÂÐÜèÌåÓýÔºÐÄѪ¹Ü²¡ÐÜèÌåÓýÔº³ÂÎÄÉúÔº³¤µ£Èδó»áÖ÷ϯ£¬Öî¶à¹úÄÚÐÄѪ¹ÜÁìÓòµÄѧÕß¹²Í¬ÌÖÂÛÐÄË¥»°Ì⣬·¢±íÕæÖª×Æ¼û£¬ÆÊÎöÐÄË¥Ç°ÑØÐÂÈȵ㣬̽ÌÖÐÄË¥ÖÎÁÆÐÂÇ÷ÊÆ£¬Ì½Ë÷ѧ¿Æ·¢Õ¹Ð·½Ïò¡£
»áÒéÒÁʼ£¬Î÷°²¸ßÐÂÐÜèÌåÓýÔºËÎçøÔº³¤¡¢³ÂÎÄÉú¸±Ôº³¤Ö»¶Ó´Ê¡£
ËÎçøÔº³¤¶ÔÓë»á¼Î±ö¼°³¤ÆÚÒÔÀ´¶ÔÎ÷°²¸ßÐÂÐÜèÌåÓýÔºÐÄѪ¹Ü²¡ÐÜèÌåÓýÔºÖ§³ÖµÄר¼Ò±íʾÖÔÐĵĸÐл£¬Ä¿Ç°ÐÄË¥ÊÇÐÄѪ¹Ü¼²²¡×îºóµÄÕ½³¡£¬ÐÜèÌåÓýÔºÒ²ÔÚ¼¯ÍÅÖ§³ÖÏ´óÁ¦ÍƽøÖصãѧ¿Æ½¨É裬ÐÄÔà´óѪ¹ÜÍâ¿ÆÒ²½ô¸úʱ´ú²½·¥£¬ÎªÉÂÎ÷Ê¡ÐÄË¥ÖÎÁÆ·¢Õ¹¹±Ï×ÁË×Ô¼ºµÄÁ¦Á¿¡£Ï£ÍûÒÔ´Ë´ÎÂÛ̳ΪÆõ»ú£¬´î½¨Á¼ºÃµÄƽ̨£¬´Ù½øÎ÷±±µØÇøÑ§¿ÆÖ®¼ä½»Á÷ºÏ×÷¡£
³ÂÎÄÉú¸±Ôº³¤Ö´DZíʾ£¬ÎÒ¹úÐÄË¥»¼²¡ÈËȺÒÑ´ïǧÍòÒÔÉÏ£¬¸÷µØÇøÐÜèÌåÓýÁÆ×ÊÔ´²»¾ùÔì³ÉÐÄË¥·ÀÖÎˮƽÈÔ´æÔڽϴó²îÒ죬ÐÄÁ¦Ë¥½ß·ÀÖι¤×÷ÈÔÃæÁÙ¼è¾ÞÌôÕ½£¬ÐèÒª¸÷λͬÈʹ²Í¬¹Ø×¢£¬íÆíÂǰÐС£
ѧÊõÑݽ²£º
´Ë´ÎÂÛ̳²ÉÓÃÏßÉÏÏßÏÂͬ²½Ö±²¥£¬ÌØÑû±±¾©º½¿Õº½Ìì´óѧÉúÎïÓëÐÜèÌåÓýѧ¹¤³ÌѧԺ³ÂÔöʤ½ÌÊÚ£¬ÖйúÐÜèÌåÓýѧ¿ÆÑ§Ôº¸·ÍâÐÜèÌåÓýÔºÇ䯽¡¢ÖÜÐÇÍ®½ÌÊÚ£¬¿Õ¾ü¾üÐÜèÌåÓý´óѧÎ÷¾©ÐÜèÌåÓýÔºÍõÇí½ÌÊÚ¡¢ÉòÃô½ÌÊÚ£¬Î÷°²½»Í¨´óѧµÚÒ»¸½ÊôÐÜèÌåÓýԺʦÌÐÜèÌåÓýÌÊÚ¡¢ËÎÑÞ½ÌÊÚ¡¢¹ù·åΰ½ÌÊÚ£¬ËÄ´¨Ê¡ÈËÃñÐÜèÌåÓýÔºÍõÒÕÆ¼½ÌÊÚ¡¢ÍõÎÄÑÞ½ÌÊÚ£¬ÉÂÎ÷Ê¡ÈËÃñÐÜèÌåÓýÔº½ªÜ°½ÌÊÚ£¬Î÷°²ÊÐÖÐÐÄÐÜèÌåÓýÔº¹¨Ãô½ÌÊÚ£¬Î÷°²¸ßÐÂÐÜèÌåÓýÔºÍõСÑà½ÌÊÚÕÅÄÜ·¼½ÌÊÚ¡¢Î¤³¿Áú½ÌÊÚ£¬Î÷µç¼¯ÍÅÐÜèÌåÓýÔºËÎÒËÉú½ÌÊÚµ£ÈÎÖ÷½²¼Î±ö¡£
¿Õ¾ü¾üÐÜèÌåÓý´óÑ§ÌÆ¶¼ÐÜèÌåÓýÔºÑÏö½ÌÊÚ¡¢±±¾©ÖÐÐÜèÌåÓýÒ©´óѧËï˼åãÐÜèÌåÓýÔºÁõÏþῸ±Ôº³¤¡¢Ö£ÖÝ´óѧµÚÒ»¸½ÊôÐÜèÌåÓýÔºÁºÕñÐ˽ÌÊÚ¡¢¿Õ¾üµÚ986ÐÜèÌåÓýÔºÍØ²½ÐÛ½ÌÊÚ¡¢Î÷°²ÊÐÈËÃñÐÜèÌåÓýԺ֧ΰΰ½ÌÊÚ¡¢±¦¼¦ÊÐÖÐÐÜèÌåÓýÐÜèÌåÓýÔºÑîÖǽÌÊÚ¡¢Î¼ÄÏÊÐÖÐÐÄÐÜèÌåÓýÔºÑîÓ½ÌÊÚ¡¢Î÷°²¸ßÐÂÐÜèÌåÓýÔºÂí¶÷½ÌÊÚ¡¢Åí½¨Ó½ÌÊÚµ£ÈÎÖ÷³ÖÈË¡£
ÂÛ̳µÚÒ»»·½ÚÒÔ×îÐÂÖ¸ÄÏÓ빲ʶ½â¶ÁΪרÌ⣬ÍõÇí½ÌÊÚ´øÀ´¡¶¼±ÐÔÐÄË¥µÄÖÎÁƽøÕ¹¡·£¬½ªÜ°½ÌÊھ͡¶ÂýÐÔÐÄÁ¦Ë¥½ß¡°ÐÂËÄÁª¡±Ò©ÎïÖÎÁÆ·½°¸ÁÙ´²½â¾ö·¾¶×¨¼Ò¹²Ê¶½â¶Á¡·£¬¹¨Ãô½ÌÊÚ´øÀ´¡¶ÂýÐÔÐÄË¥¼ÓÖØ»¼Õßר¼Ò¹²Ê¶¡·£¬ÉòÃô½ÌÊÚ´øÀ´¡¶ÐÄË¥Ö¸Äϼ°CRTÊÊÓ¦Ö¢¡·£¬¾ÍÂýÐÔÐÄË¥»¼ÕßÓ¦ÓÃCRTÖÎÁƵÄΧÊõÆÚ¹ÜÀí½øÐÐ×÷¾Ñé·ÖÏí¡£
ÖйúÐÜèÌåÓýѧ¿ÆÑ§Ôº¸·ÍâÐÜèÌåÓýÔºÇ䯽½ÌÊÚÒÔÏßÉÏÖ±²¥µÄ·½Ê½´øÀ´¡¶LVAD»¼ÕßÊõǰÓÅ»¯¡·µÄ±¨¸æ£¬´ÓºòÑ¡ÕßÊõǰÆÀ¹À£¬ÉîÈëÁ˽ⲡÈËÇé¿öÖ®ºó£¬Î§ÈÆÖÎÁÆÓÃÒ©¡¢²¡Ö¢·ÖÎö¡¢¿¹Äý²ßÂÔÒ©Îᄀ¿ÉÄÜÓÅ»¯Êõǰ״̬£¬Ìá¸ßÉú´æÂʺͼõÉÙ²¢·¢Ö¢¡£
ÖÜÐÇÍ®½ÌÊÚ´øÀ´¡¶´ÈæÚVAD¸·ÍⳤÆÚËæ·Ã½á¹û¡·£¬½²Ìâ·Ö±ð´Ó¹úÄÚLVADÏÖ×´/¸·ÍâÐÜèÌåÓýÔºLVADµ¥ÖÐÐľÑé¼°³¤ÆÚËæ·Ã½á¹û½øÐзÖÏí£¬ÎªÁÙ´²LVADµÄ¹ÜÀíÌṩǿÓÐÁ¦µÄÊý¾ÝÖ§³Å¡£
Î÷°²½»Í¨´óѧµÚÒ»¸½ÊôÐÜèÌåÓýÔº¹ù·åΰ½ÌÊھ͡¶»úеѻ·Ö§³Ö×°ÖÃÁÙ´²Ó¦ÓõÄÏÖ×´¼°Î´À´¡·½øÐзÖÏí£¬½üЩÄ꣬ÎÒ¹úVAD¼¼Êõ´ÓÑÐÖÆµ½ÖÎÁÆÓÀ´ÁËÍ»·ÉÃͽøµÄ·¢Õ¹×÷ΪÐÄÔàÒÆÖ²Ç°ÇŽÓÖÎÁƵÄÖØÒªÊÖ¶ÎÖ®Ò»£¬»úеѻ·Ö§³Ö×°Öã¨MCS£©¿ÉÏÔÖøÌá¸ßÖÕÄ©ÆÚÐÄÁ¦Ë¥½ß»¼ÕßµÄÉú»îÖÊÁ¿ºÍÉú´æÂÊ¡£
±±¾©º½¿Õº½Ìì´óѧÉúÎïÓëÐÜèÌåÓýѧ¹¤³ÌѧԺ³ÂÔöʤ½ÌÊÚ×÷ÁËÌâΪ¡¶È˹¤ÐÄÔà¹Ø¼ü¼¼ÊõºÍѪҺËðÉË»úÀíÑо¿¡·µÄ±¨¸æ£¬È˹¤ÐÄÔàÑз¢ºÍÓÅ»¯ÓëÐÜèÌåÓýѧ¡¢ÉúÎï¡¢¹¤³ÌµÈ¶àѧ¿Æ½ôÃÜÏà¹Ø´ÓÉúÎïÐÜèÌåÓýѧ¹¤³Ì½Ç¶È·ÖÏíÁËÈ˹¤ÐÄÔàµÄ½á¹¹Éè¼ÆÓë¹Ø¼ü¼¼Êõ£¬ÒÔ¼°ÑªÒºËðÉËÏà¹ØÑо¿½á¹û£¬ÉîÈëÍÚ¾òÈ˹¤ÐÄÔàССÆ÷еÑз¢±³ºóËùÃæÁÙµÄÖî¶àÄѵ㡣
ÍõÒÕÆ¼½ÌÊÚ£¬ÍõÎÄÑÞ½ÌÊÚ·Ö±ð¾Í¡¶CRRTÖÎÁÆÔÚÐÄÁ¦Ë¥½ß»¼ÕßÖеÄÓ¦Óá·£¬¡¶×óÐÄÊÒ¸¨Öú£¨LVAD£©ÊÊÓ¦Ö¢¼°»¼Õßɸѡ¡·½øÐÐÏßÉÏÖ±²¥·ÖÏí¡£ÍõСÑà½ÌÊÚ´øÀ´¡¶â§ËÀµÄ³£¼ûÔÒò/Ô¤·ÀºÍ¼±¾È¡·£¬ËÎÑÞ½ÌÊÚ´øÀ´¡¶³¬ÉùÔÚLVADΧÊõÆÚÖеÄÓ¦Óá·£¬³ÌÁÁ½ÌÊÚ´øÀ´¡¶ECMOÔÚÐÄË¥»¼ÕßÖÎÁÆÖеÄÓ¦Óá·¡£
×îºóÁÙ´²²¡Àý¼°¾Ñé·ÖÏí»·½Ú£¬Ê¦ÌÐÜèÌåÓýÌÊھ͡¶LVADΧÊõÆÚ¹ÜÀí¼°²¢·¢Ö¢Ô¤·À¡·¡¢ËÎÒËÉú½ÌÊÚ¡¢Î¤³¿Áú½ÌÊÚ¡¢ÕÅÄÜ·¼½ÌÊÚ·Ö±ð´ÓÒ©ÎïÖÎÁÆ¡¢ECMO¸¨Öú¡¢LVADÖ²Èë½øÐÐÁ˲¡Àý·ÖÏí¡£
ÂÛ̳ÌÖÂÛ»·½Ú£¬²Î»áר¼ÒѧÕßÈÈÇé¸ßÕÇ£¬ÉîÈë̽ÌÖÐÄË¥ÁìÓòµÄÈȵãÎÊÌ⣬¿ªÀ«ÁËÁÙ´²Ë¼¿¼µÄ½Ç¶ÈºÍά¶È¡£
³ÂÎÄÉú¸±Ôº³¤ÔڻβÉù×ܽáµÀ£¬ÐÄË¥ÖÎÁÆÎ§ÊõÆÚµÄ¹ÜÀíÊÇÒ»¸öÐèÒª³ÖÐøÑ§Ï°µÄ¹ý³Ì£¬ÆÚ´ýδÀ´Óë¸÷λͬµÀ±£³Ö³¤ÆÚºÏ×÷¹µÍ¨£¬·ÖÏí¸ü¶àÁÙ´²¾Ñ飬Ϊ¸ü¶àÐÄË¥»¼ÕßÉú»îÖÊÁ¿µÄÌáÉýÌṩ¸ü¶àµÄÑ¡Ôñ¼°Ö¤¾ÝÖ§³Ö£¡