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NEJM:高大上磁悬浮技术不仅用于列车,还可用于晚期心衰患者的治疗!!!

2016-11-17 xing.T MedSci原创

由此可见,在晚期心脏衰竭的病人中,相比于植入轴流泵,植入全磁悬浮离心式连续流动泵在术后6个月取得更好的预后,主要是由于较低的因泵故障而再手术率。

持续流动式左心室辅助系统提高了晚期心力衰竭患者的生存率,但其与泵内血栓形成密切相关。近日,顶级医学期刊NEJM上发表了一篇研究文章,旨在介绍一种新的磁悬浮离心式连续流动泵,主要用于防止血栓形成。

研究人员将晚期心衰患者随机分组,分别接受新的离心式连续流动泵或已经商业化的轴向连续流动泵。不论泵支持治疗的目标(坚持到心脏移植或终点治疗),这些泵支持治疗患者都可以被纳入研究。研究的主要终点为无致残性卒中的复合生存率(致残性卒中是指改良的Rankin评分>3;该评分分数范围为0-6分,分数越高表明残疾越严重)或在术后6个月不再进行手术更换或移除装置的生存率。该试验对主要终点进行非劣效性检验(非劣效性边界为−10%)。


该研究共有294例患者,其中152例被分配到离心泵组,另外142例被分配入轴流泵组。在意向治疗人群中,在离心泵组发生主要终点事件的患者有131例(86.2%),在轴流泵组有109例(76.8%)(绝对差为9.4%;95%置信下限为−2.1 [非劣效性P<0.001];风险比为0.55;95%可信区间为0.32-0.95 [优势P双侧=0.04])。两组间死亡或致残性卒中率无明显差异,但因泵的故障再次手术的频率在离心泵组明显低于轴流泵组(1[0.7%] vs. 11[7.7%];风险比为0.08;95%可信区间为0.01-0.60;P=0.002)。疑似或确诊的泵内血栓在离心泵组无一例发生,而轴流泵组为14例(10.1%)。

由此可见,在晚期心脏衰竭的病人中,相比于植入轴流泵,植入全磁悬浮离心式连续流动泵在术后6个月取得更好的预后,主要是由于较低的因泵故障而再手术率。

原始出处:

Mandeep R. Mehra, et al. A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure. NEJM. November 16, 2016.

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    2016-12-04 1e0ece0dm09(暂无匿称)

    谢谢谢谢分享

    0

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    2016-11-24 李东泽

    很好,不错,以后会多学习

    0

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    2016-11-18 医张生

    所以医学生必须先学理工科。

    0

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    2016-11-18 明崖

    有道理,任何可以治病救人的措施都是好的

    0

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    2016-11-18 天下第一海

    厉害了

    0

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    2016-11-18 txqjm

    谢谢了,学习了

    0

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    2016-11-17 䖝二

    高大上啊,产学研才是出路,化为生产力才是金标准啊

    0

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