如何建设介入-外科手术室_蒋世良.ppt

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,Hybrid Room,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。,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。,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。,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 心脏麻醉医生 电生理医生 护士 介入手术室技术员 灌注师,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

2、管造影机需要至少70m2,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,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,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）,杂交手术室显像设备,平板监视器 麻醉科医生 超声心动图医生 介入医生,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）,杂交方法治疗冠心病多支病变,冠脉搭桥术后（CABG） 行PCI治

3、疗多支病变,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,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,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,法乐氏四联症术前经导管栓塞体肺侧支,经导管栓塞体肺侧支血管,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,Thank you for your attention ！,How to Build a Cath-Lab Operating Room （Hybrid Operating Room）,Department of Radiology, Cardiovascular Insti

4、tute & Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China, 100037 Shiliang Jiang, MD 蒋世良,Hybrid Room,Background（1）,Historically, surgeons and interventionalists have had a somewhat competitive relationship, especially in coronary artery disease and cong

5、enital heart disease.,Background（2）,The management of some acquired and congenital cardiovascular diseases is evolving due to advances in trans-catheter therapies that coincide with surgical strategies to improve outcomes.,Background（3）,As the level of collaboration between the surgeon and intervent

6、ionalist has increased, the need for a therapeutic suite that is compatible with both disciplines（hybrid）has become apparent.,Staff Involved In A Hybrid Case,Interventionalist Cardiovascular Surgeon Echo-cardiographer Cardiac anesthesiologist Electrophysiologist Nurses Cath Lab Technicians Perfusion

7、ist,Hybrid Room Design,The room size : should be minimum of 80 m2 for bi-plane systems 70 m2 for sigle-plane systems,Space Considerations,Floor space reserved for: Angiographic system Anesthesia machine Echocardiography machine CPB machine,Integrated Operation Table with floating table top,Product f

8、eatures : Integrated table is the pre-requisite for 3D imaging Floating table top Collision Protection Motorized tilting capabilities: 15 head up/Down 15 lateral tilt Carbon fibre table top,Space Considerations,Equipment mounted on ceiling/walls: Surgical light Contrast injector Zoom camera mounted

9、on the wall,Hybrid Room Video Display,Flat panel monitors around the room for: Anesthesiologist Echo-cardiographer Interventionalist,Information Transport,Angiograms Echocardiograms(TTE,TEE,IVUS,3D) Physiology monitoring Live video Other video sources-PACS,Hybrid Procedures for the Treatment of CAD

10、with Multiple Vessels Disease,CABG prior to PCI for CAD with Multiple Vessels Disease,CABG prior to PCI for CTO withLAD and RCA Stenosis,Percutaneous Closure of Aortopulmonary Collaterals,Prior to intracardiac operation for Tetralogy of Fallot,Percutaneous Closure of Aortopulmonary Collaterals,Prior to intracardiac operation for Tetralogy of Fallot,Percutaneous Closure of Aortopulmonary Collaterals,Prior to intracardiac operation f