機械性循環輔助

Mechanical Circulatory Support

吳英黛(Ying-Tai Wu) ； 王水深(Shoei-Shen Wang)

《中華民國物理治療學會雜誌》 22卷1期 (1997/01) Pp. 69-79

https://doi.org/10.29616/JPTAROC.199701.0008

摘要

機械性循環輔助裝置可有效地挽救心臟衰竭的病人，增加病人的存活，或者維持適當的血液循環，以便進一步的治療。可分為短期和長期的輔助裝置，前者多經皮插入，後者主要指的是心室輔助器和全人工心臟，則需靠手術植入。在何時植入何種裝置主要由醫師依病人情況而定，治療師應對機械性循環輔助裝置有基本的認識，在病人使用這些裝置時，有效提供呼吸照顧，並協助病人功能活動和運動訓練。本文主要涵蓋機械性循環輔助系統的概述，包括適應症、常見的種類、置入方法、併發症以及長期性裝置對循環生理的影響，同時簡單介紹長期使用循環輔助系統者的功能調適、生活品質以及機械性循環輔助器的研發現況。

關鍵字

機械性循環輔助系統 ； 物理治療

並列摘要

Mechanical circulatory support devices are effective in saving patients from failing hearts. They are different in the degree of support and in the invasiveness of device insertion. Physicians in charge decide the timing of device application and choice of an appropriate device in a specific clinical setting. Therapist should understand 1) the basic types of the circulatory support; 2) the functions of these devices; 3) the mechanisms of the devices and precautions while working or exercising with patients having such assistive devices. This article provides the overviews of the indications, complications, and commonly available models of short-term and long-term supportive devices. The operative procedures of implantable ventricular assistive device (VAD) and total artificial heart (TAH) and postoperative recovery are described. The TAH devices are often have venous return sensitivity less than optimal and limitations in maximal flow. The other physiological changes related to TAH are also addressed. Experiences in many medical centers around the world have made possible to optimize patients' general condition and improve their chance of survival. Some of these patients have been discharged from hospital and survived over 1 year. Researches have been undergone even no devices are approved for permanent implantation at the present time.

並列關鍵字

Mechanical circulatory support ； Physical therapy