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中华重症医学电子杂志 doi: 10.3877/cma.j.issn.2096-1537.2025.04.02-0008

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机械循环辅助技术在心源性休克患者中的应用与展望
郝光伟1, 黄丹蕾1, 屠国伟1, 罗哲1,()   
  1. 1. 200032 上海,复旦大学附属中山医院心脏重症监护中心
  • 收稿日期:2025-01-30
  • 通信作者: 罗哲
  • 基金资助:
    上海市卫生健康委员会卫生行业研究专项(卓越项目)(20234Z0010)

Mechanical circulatory support in cardiogenic shock:applications and future directions

Guangwei Hao1, Danlei Huang1, Guowei Tu1, Zhe Luo1,()   

  1. 1. Center of Cardiac Intensive Care Unit, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
  • Received:2025-01-30
  • Corresponding author: Zhe Luo
引用本文:

郝光伟, 黄丹蕾, 屠国伟, 罗哲. 机械循环辅助技术在心源性休克患者中的应用与展望[J/OL]. 中华重症医学电子杂志, doi: 10.3877/cma.j.issn.2096-1537.2025.04.02-0008.

Guangwei Hao, Danlei Huang, Guowei Tu, Zhe Luo. Mechanical circulatory support in cardiogenic shock:applications and future directions[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), doi: 10.3877/cma.j.issn.2096-1537.2025.04.02-0008.

机械循环辅助(MCS)技术在各种原因引起的心源性休克(CS)的治疗中发挥重要作用,选择合适的时机及合理的技术支持是救治成功的关键。本文就常用MCS技术在CS患者中的应用进行综述。

Mechanical circulatory support play an important role in the treatment of cardiogenic shock due to various etiologies. Selecting the appropriate timing and providing reasonable technical support are key to successful treatment. We will review the application of commonly used mechanical circulatory support technologies in cardiogenic shock.

图1 主动脉内球囊反搏工作原理示意图。在心脏舒张前一瞬间(心电触发为T波终点,压力触发为动脉压力切迹点),球囊快速充气,增加舒张期冠脉灌注压力,增加心肌供氧;在心脏收缩前一瞬间(心电触发为QRS波前,压力触发为舒张末压点),球囊快速放气,降低主动脉内舒张末压,降低后负荷,减少左心室做功,减少心肌氧耗
图2 常用左心室辅助装置 注:IABP为主动脉内球囊反搏;VA-ECMO为静脉-动脉体外膜肺氧合
图3 常用右心室及双心室辅助装置 注:VA-ECMO为静脉-动脉体外膜肺氧合;CPR为心肺复苏;ECPR为体外循环心肺复苏
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