医学专题如何建设介入-外科手术室-蒋世良

1、如何建设介入外科手术室（杂交手术室）中国医学科学院阜外心血管病医院放射科.蒋世良2021/7/19 星期一1Hybrid Room2021/7/19 星期一2背景（1）心血管外科和介入心脏医生在过去存在一种竞争关系，特别是在冠心病和先心病治疗领域。2021/7/19 星期一3背景（2）一些获得性和先天性心血管疾病采用经导管介入治疗和配合心外科治疗，提高了治疗效果。2021/7/19 星期一4背景（3）随着介入心脏病医生和心血管外科医生合作的不断加强，适合这两种治疗方法共同的手术室（杂交手术室）出现了。2021/7/19 星期一5杂交手术时需要的人员介入医生心血管外科医生 超声心动图医生心脏麻醉

2、医生电生理医生护士介入手术室技术员灌注师 2021/7/19 星期一6杂交手术室设计 房间空间要求 双球管造影机需要至少80m2 单球管造影机需要至少70m22021/7/19 星期一7空间要求地面预留空间给下列设施 心血管造影机 麻醉机 超声设备 体外循环设备2021/7/19 星期一8手术床与可移动床的结合产品特征：三维成像的需要床可浮动、移动防震动 旋转角度 15 头侧抬高 / 降低 15 侧面倾斜 碳纤维床面 2021/7/19 星期一9空间方面的考虑设备垂吊或安装在墙壁上 手术灯 造影剂注射器 可变焦照相机（摄影机）2021/7/19 星期一10杂交手术室显像设备平板监视器 麻醉科医

3、生 超声心动图医生 介入医生2021/7/19 星期一11信息传输造影图像超声图像（经胸、经食道、血管内超声和三维超声图像）生理监护仪实时录像其它图像PACS（图像存储与传输系统）2021/7/19 星期一12杂交方法治疗冠心病多支病变冠脉搭桥术后（CABG） 行PCI治疗多支病变2021/7/19 星期一13先采用CABG治疗LAD阻塞性病变，后行PCI支架治疗右冠状动脉狭窄 2021/7/19 星期一14经导管栓塞体肺侧支血管 法乐氏四联症术前经导管栓塞体肺侧支 2021/7/19 星期一15经导管栓塞体肺侧支血管 法乐氏四联症术前经导管栓塞体肺侧支 2021/7/19 星期一16法乐氏四

4、联症术前经导管栓塞体肺侧支 经导管栓塞体肺侧支血管 2021/7/19 星期一17经导管栓塞体肺侧支血管 法乐氏四联症术后经导管栓塞体肺侧支 2021/7/19 星期一18Thank you for your attention ！2021/7/19 星期一19How to Build a Cath-Lab Operating Room （Hybrid Operating Room）Department of Radiology, Cardiovascular Institute & Fuwai Hospital,Peking Union Medical College & Chinese A

5、cademy of Medical Sciences Beijing, China, 100037Shiliang Jiang, MD蒋世良2021/7/19 星期一20Hybrid Room2021/7/19 星期一21Background（1）Historically, surgeons and interventionalists have had a somewhat competitive relationship, especially in coronary artery disease and congenital heart disease. 2021/7/19 星期一22B

6、ackground（2）The management of some acquired and congenital cardiovascular diseases is evolving due to advances in transcatheter therapies that coincide with surgical strategies to improve outcomes.2021/7/19 星期一23Background（3）As the level of collaboration between the surgeon and interventionalist has

7、 increased, the need for a therapeutic suite that is compatible with both disciplines（hybrid）has become apparent. 2021/7/19 星期一24Staff Involved In A Hybrid CaseInterventionalistCardiovascular Surgeon Echo-cardiographerCardiac anesthesiologistElectrophysiologistNursesCath Lab TechniciansPerfusionist

8、2021/7/19 星期一25Hybrid Room Design The room size : should be minimum of 80 m2 for bi-plane systems 70 m2 for sigle-plane systems2021/7/19 星期一26Space ConsiderationsFloor space reserved for: Angiographic system Anesthesia machine Echocardiography machine CPB machine2021/7/19 星期一27Integrated Operation T

9、able with floating table top Product features :Integrated table is the pre-requisite for 3D imagingFloating table topCollision Protection Motorized tilting capabilities: 15 head up/Down 15 lateral tilt Carbon fibre table top 2021/7/19 星期一28Space ConsiderationsEquipment mounted on ceiling/walls: Surg

10、ical light Contrast injector Zoom camera mounted on the wall2021/7/19 星期一29Hybrid Room Video DisplayFlat panel monitors around the room for: Anesthesiologist Echo-cardiographer Interventionalist 2021/7/19 星期一30Information TransportAngiogramsEchocardiograms(TTE,TEE,IVUS,3D)Physiology monitoringLive v

11、ideoOther video sources-PACS2021/7/19 星期一31Hybrid Procedures for the Treatment of CAD with Multiple Vessels DiseaseCABG prior to PCI for CAD with Multiple Vessels Disease2021/7/19 星期一32CABG prior to PCI for CTO withLAD and RCA Stenosis 2021/7/19 星期一33Percutaneous Closure of Aortopulmonary Collaterals Prior to intracardiac operation for Tetralogy of Fallot 2021/7/19 星期一34Percutaneous Closure of Aortopulmonary CollateralsPrior to intracardiac operation for Tetralogy of Fallot 2021/7/19 星期一35Percutaneous Closure of Aortopulmonary Collaterals Prior to intracardiac operation for Tetralogy of Fal