VENTRIKULYAR YORDAM QURILMALARI VA NOKARDIOLOGIK JARROHLIK: PERIOPERATIV BOSHQARUV
Kalit so'zlar:
ventrikulyar yordam qurilmasi (VYQ); chap qorincha yordam qurilmasi (LVAD); HeartMate II; HeartWare HVAD; nokardiologik jarrohlik; perioperativ boshqaruv; antikoagulyatsiya; transezofageal exokardiyografiya (TEE).Annotatsiya
Ushbu maqolada ventrikulyar yordam qurilmalari (VYQ) bilan yashayotgan bemorlarni nokardiologik jarrohlik muolajalariga tayyorlash, intraoperativ boshqarish va postoperativ kuzatish masalalari ilmiy adabiyotlar asosida ko'rib chiqilgan. VYQlar, xususan chap qorincha yordam qurilmalari (CHQYQ/LVAD), yurak yetishmovchiligini davolashda tobora keng qo'llanilmoqda. AQSh da 5,8 million yurak yetishmovchiligi bemorlari mavjud bo'lib, har yili 670,000 yangi holat qayd etiladi. REMATCH klinik sinovida (129 bemor) va INTrEPID sinovida (55 bemor) LVAD terapiyasi optimal tibbiy terapiyaga nisbatan 2 yillik omon qolishni deyarli 3 barobar oshirganligi isbotlangan. LVAD bemorlari nokardiologik jarrohlikka 23–27% hollarda muhtoj bo'ladi. Maqolada qurilma fiziologiyasi, antikoagulyatsiya boshqaruvi, hemodynamik monitoring va intraoperativ ehtiyot choralar batafsil yoritilgan. Xulosaga ko'ra, ushbu bemorlarni muvaffaqiyatli davolash uchun ko'p tarmoqli mutaxassislar hamkorligi va LVAD fiziologiyasini chuqur tushunish muhim ahamiyat kasb etadi.
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