年轻妈妈带着人工心脏康复出院
Young Mother with anArtificial Heart Implant is Discharged from Hospital
极目新闻记者 晏雯 通讯员 朱玉凤 昌金星 翻译：杨珂 卫拉 严佳薇（湖北大学）
Jimu News Reporter: Yan Wen Correspondents: Zhu Yufeng, Chang Jinxing Translators: Yang Ke, Lisa M.K, Yan Jiawei (Hubei University)
医护团队祝贺陈月顺利康复 （武汉大学人民医院供图 ）
The medical team congratulates Chen Yue on her recovery Source: RenminHospital ofWuhan University
“我做了一个梦，梦里我和孩子一起向前奔跑。”9月20日，29岁的陈月（化名）在武汉大学人民医院（湖北省人民医院）的病床上醒来。3天前，她接受了高难度人工心脏植入手术。她的胸口传出微弱的“嗡嗡”声，那是人工心脏运行的声音，也是她逃脱死神魔爪的信号。
“I had a dream, I was runningforward with my daughter.”Chen Yue (pseudonym), 29 years old, woke up in a bed at Renmin Hospital of Wuhan University(Hubei General Hospital)on September 20th. Three days prior, she underwent a highly complex surgery to implant an artificial heart. A faint “buzzing”sound came from her chest, which was the sound of her artificial heartat work, and more so a reminderthat she had escaped the clutches of death.
11月9日，是陈月接受人工心脏植入后的第 53天，也是她出院的日子。由于心脏受损，无法正常运行，她只能依靠小小的人工心脏，让血液流遍全身。
On November 9th, 53 daysafterthesurgery, Chenwas discharged from the hospital. She had to rely on the small artificial heart to keep blood flowing throughout her body after damage to her heart rendered it obsolete.
数度经历生死，陈月觉得自己是被幸运之神眷顾的人。她说：“我现在最大的感受，就是活着真好！”
Having fought between lifeanddeath several times, Chen felt she was favored by the God of Luck. “Rightnow,it just truly feels great to be alive!”
死神突袭年轻产妇
Young Mom-to-be Facedwith the Threat of Death
今年6月，29岁的陈月怀胎十月诞下女儿。喜讯还未持续多久，她便出现心慌、咳嗽、呕吐、喘气、不能平卧等症状，随后被确诊为围产期心肌病。
In June this year, Chen Yue gave birth to her daughter after ten months of pregnancy. However, the happiness was short-lived as she developed symptoms including palpitations, coughing, vomiting, wheezing and difficulty lying flat, and was subsequently diagnosed with peripartum cardiomyopathy.
从6月到8月，陈月辗转于多家医院。但药物治疗效果不佳，全家人愁容满面。
From June to August, Chen Yue visited numerous hospitals. The medication, however, was not helping, leaving the family at a loss.
9月初，陈月突发呼吸衰竭，被家人紧急送往武汉大学人民医院心内科接受治疗。9月9日，她出现意识丧失，瞳孔散大，心电监护提示室颤。心内科、急诊科、重症医学科立即组织抢救，紧急心肺复苏、气管插管后，陈月戴着呼吸机进入重症医学科Ⅱ科救治。
At the beginning of September, Chen Yue suffered a sudden respiratory failure and was urgently taken to the Cardiology Department of Renmin Hospital of Wuhan Universityby her family for treatment. On September 9th, she becameunconsciousness and had dilated pupils, withthe ECG indicating she was experiencing ventricular fibrillation. The Cardiology Department, Emergency Department and Intensive Care Unit immediately organized rescue efforts. After emergency CPRand endotracheal intubation, Chen Yue was placed on a ventilator and admittedto Intensive Care Unit Ⅱfor treatment.
围产期心肌病，是指孕产妇在分娩前3个月至产后6个月之间出现的心肌不可逆损伤，是以心腔扩大、心力衰竭、心律失常等为主要表现的一种特殊类型心肌病。其发病与遗传因素、感染因素、炎性反应、免疫损伤等一系列因素相关，病程中可能并发恶性心律失常、心力衰竭而猝死。
Peripartum cardiomyopathy, refers to irreversible cardiac damage that occurs within the 3 months before childbirth and 6 months postpartum. It is a special type of cardiomyopathy characterized by an enlargement of the heart, heart failure and arrhythmia. The causesvaryfromgenetic factors, infections, inflammation, toimmune damage. During the course of the disease, malignant arrhythmia, heart failure, and sudden death may occur.
“危重病人是‘守’活的！”这是重症医学科Ⅱ科主任余追长期坚持的理念。从陈月入住病房的第一天起，他带领团队打响了这场“生命守卫战”。
“Our perseverance is what saves patients in critical condition!”These are the words that Yu Zhui, the director of ICU Ⅱ, has long adhered to. He has led the team on a “life saving war”since Chen Yue’s first day in the ward.
反复室颤、意识丧失、瞳孔散大……短短3天里，陈月室颤21次。为了除颤，她胸前的皮肤几乎被电焦。随着病情进展，她的左心室不断扩张，心脏接近“罢工”，种种症状还导致左心室内并发血栓。
Recurrent ventricular fibrillation, loss of consciousness, dilated pupils...In only 3 days, Chen Yue experienced ventricular fibrillation 21 times. Efforts to administer defibrillation left the skin on her chest was almost burned by the current of defibrillator. As her condition deteriorated, her left ventricle continued to dilate, her heart was nearly “going on strike”, with various symptoms further leading to thrombosis in the left ventricle.
雪上加霜的是，由于心脏射血不足，导致血压过低，陈月出现脑、肝、肾、胃肠等多器官功能衰竭。9月12日，重症医学Ⅱ科与心血管外Ⅱ科团队决定，给陈月紧急进行体外膜肺氧合（ECMO）和肾脏替代治疗。
Further adding fuel to fire, the insufficient a lowcardiac ejection led to low blood pressure, resulting inmultiple organ failurefor Chen Yue, including her brain, liver, kidneyandgastrointestinalsystem, among others. On September 12th, the teams in the Intensive Care Unit Ⅱand Cardiovascular Surgery Ⅱdecided to immediately treat Chen Yue with Extracorporeal Membrane Oxygenation (ECMO) and Renal Replacement Therapy.
尽管如此，陈月依然反复发生“电风暴”。多学科救治团队反复研讨后认为，心脏外科手术干预是保住她生命的唯一出路。
Despite all efforts, Chen Yue still experienced “ventricular arrhythmia storms”repeatedly. Following much discussion, the multidisciplinary team concluded that cardiac surgical intervention was the only way to save her life.
人工心脏带来希望
Artificial heart brings hope
“心脏好比水泵。正常功能的心脏会把血抽回来，再规律地泵出去。但她的心脏没有能力把血泵出去，从而像气球一样越来越大，血压越来越低。如果等不到合适的心脏移植供体，人工心脏植入是唯一的保命办法。”心血管外Ⅱ科主任夏军向陈月的家属解释她的病情。
“The heart is like a waterpump. A normal functioning heart will pump blood away from and back to the heart regularly. However, Chen’s heartisunable to pump the blood out, and similar to a balloon it grew in size, lowering her blood pressure. If there is no suitable heart donor, an artificial heart implant is the only way out.” Xia Jun, director of the department of cardiovascular surgery II, said to Chen Yue’s family.
陈月的丈夫说：“不管结局怎样，我们都要努力救她。拜托医生尽最大的努力。”
Chen Yue’s husband said, “We have to try and save her regardless of the result. Please, doctor, do what you must.”
患者家属的支持与理解，让夏军深受感动，也坚定了成功救治的信心。
The support and understanding of the patient’s family touched Xia Jun deeply and strengthened his confidence to provide successful treatment.
夏军告诉极目新闻记者，人工心脏分为左心室辅助、右心室辅助和双心室辅助。陈月主要是左心室功能衰竭，因此只需要植入左心室辅助装置，补充原有心脏无法提供的部分心输出量。
Xia Jun told Jimu News that artificial hearts are divided into left ventricular assist, right ventricular assist, and biventricular assist. Chen Yue, mainly suffering from left ventricular failure, only needed to implant a left ventricular assist device to supplement part of her cardiac output that her natural heart could not provide.
尽管人工心脏植入已在武汉大学人民医院常规开展，但对围产期心肌病患者同时带有ECMO、透析机、呼吸机的状态下，进行小切口人工心脏植入术，却是全球罕见。
Despite artificial heart implants being a common routine surgeries at Renmin Hospital of Wuhan University, small-incision artificial heart implant in a perinatal cardiomyopathy patient with ECMO, dialysis machine, and ventilator at the same time is rare worldwide.
为确保这台高难度手术顺利进行，在医院全力支持和关心下，心血管外Ⅱ科多次组织多学科、国内外联合会诊。参与线上会诊的有来自美国和中国北京、上海、杭州等地的心脏外科专家，以及武汉大学人民医院心外科、重症医学科、心内科、麻醉科、超声科、康复科等科室专家。诊疗团队就手术方式、手术风险、手术时机、术后可能并发症以及近远期获益等关键问题进行充分讨论，制定各种预案，然而方案迟迟未能确定。
With the full support and care of the hospital, the department of cardiovascular surgery II organized several multidisciplinary, domestic and international joint consultations to ensure the smooth progress of this difficult surgery. Participants in the online consultation were cardiac surgery experts from the United States, Beijing, Shanghai, and Hangzhou, as well as experts from the department of cardiovascular surgery, critical care medicine, cardiology, anesthesiology, ultrasound, and rehabilitation of Renmin Hospital of Wuhan University. The team held a thorough discussion on key issues such as surgical approach, surgical risks, timing of the surgery, possible postoperative complications, and short-term and long-term benefits. Despite creating multiple options for an action plan, making the final decision did not come easily.
“She is dying，we must do something right now（她的生命正在消逝，我们必须赶紧做点什么）！”曾领导美国首例左心室辅助装置植入手术的Karl教授参与会诊时表示。
“She is dying, we must do something right now!” Professor Karl, who had led the first left ventricular assist device implant in the United States, said when he participated in the consultation.
9月16日，专家团队最终拍板：立即为陈月进行人工心脏植入手术。
On September 16, the team of experts made a final decision: Chen Yue should undergo artificial heart implant immediately.
9月17日上午，陈月被送进手术室。为将手术风险和创伤降到最低，夏军决定采用微创方式。
On the morning of September 17, Chen Yue was admitted to the operating room. To minimize the risks and trauma of the surgery, Xia Jun decided to use a minimal invasive approach.
8个小时后，陈月的丈夫终于等到“手术成功”的好消息。
Eight hours later, Chen Yue’s husband finally received good news that the operation was successful.
生命守护助她闯关
Fighting for Her Life Post-Surgery
植入人工心脏后，护佑陈月生命的战斗仍未停止，与死神的较量还在继续。
After the artificial heart implant, the battle for Chen Yue’s life was not over, her fight with death was still imminent.
陈月术后被立即转入重症医学Ⅱ科。如何做好人工心脏和透析的抗凝又不至于引起出血？如何稳定血压维持内环境稳定？如何预防各种管路引起的多部位感染？如何精确调整多种升压药、补液及肾脏替代治疗的参数？如何做好后续各种管路的维护和体外生命支持的护理……一个个难关都需要不断攻克。
Chen Yue was immediately transferred to the department of critical care medicine II after surgery. How were they to effectively perform anticoagulation of the artificial heart and dialysis without causing bleeding? How would the blood pressure be stabilized to maintain a stable internal environment? How would they prevent multi-site infections caused by various catheters? How were they to accurately adjust the parameters of various antihypertensive drugs, rehydration, and renal replacement therapy? How was the subsequent maintenance of various catheters and extracorporeal machines to be done? All such difficulties had to be overcome.
重症医学Ⅱ科主任余追带领全科医护团队，与相关学科一起认真考量每一个关乎患者生命安危的细节，精益求精地实施全方位监测、治疗和护理，严密观察体温、血压、管道内血液颜色及循环情况等，针对各个方面的问题制定详细周密的治疗计划，如抽丝剥茧般逐步攻克各个难题。
Yu Zhui, director of the Department of Critical CareMedicine II, led the entire medical and nursing team, and related disciplines to carefully consider every detail that could affect the patient's condition. They strive to implement a full range of monitoring, treatment, and nursing care. In addition, they also observe patient’s body temperature, blood pressure, the color of the blood in the drip and circulation. They formulated a detailed treatment plan for each problem, patiently overcoming each successively.
“我做了一个梦，梦里我和孩子一起向前奔跑。”9月20日，术后醒来的陈月说。
“I had a dream whereI was running forward with my child.” Chen Yue, who woke up on September 20 after surgery, said.
带着这份力量，配合重症团队，她先后闯过了术后感染、肾衰无尿、凝血功能障碍引发出血等多重难关。
With this strength, she cooperated with the critical care team overcoming multiple challenges such as postoperative infection, renal failure without urine, and bleeding caused by a coagulation dysfunction.
9月22日凌晨3时许，在家休息的余追从梦中惊醒，梦里他正在陈月的病床边商量病情。他立即给科室医护打电话，询问陈月的情况。“我们一直守在身边，患者出现了难以纠正的低血压。”医护人员说。
At about 3:00 a.m. on September 22, Yu Zhui, who was resting at home, woke up from a dream in which he was discussing Chen Yue's condition at her bedside. He immediately called the department's medical personnel to inquire about Chen Yue's condition. “We've been keeping watch, and the patient has a low blood pressure and doesn’t seem to be improving.” a medical caregiver said.
情况紧急，余追匆忙赶到医院。经过数小时的悉心处理，陈月终于转危为安。
As the situation was urgent, Yu Zhui rushed to the hospital. After several hours of careful treatment, Chen Yue was eventually out of danger.
医学创造生命奇迹
Medicine creates miraculously saves lives
持续近2个月的守护，多学科团队的汗水与付出，让陈月的病情逐渐稳定下来。
The efforts made by the multidisciplinary team have gradually stabilized Chen Yue's condition over the past two months.
心血管外科医护人员连续多个日夜坚守在患者床旁，根据超声和血流动力学指标调整人工心脏的各项参数，最大程度保证患者的血流动力学和各脏器功能的稳定。康复科张旃教授结合患者情况，制定了一系列心血管康复训练计划。陈月慢慢好转：10月3日，可下床活动；10月9日，顺利转入心外科普通病房；11月9日，康复出院。
The cardiovascular surgery staff spent several days at the patient's bedside. They adjusted the parameters of the artificial heart according to the ultrasound and hemodynamic indexes to maximize the stability of the patient's hemodynamics and the function of each organ. Professor Zhang Zhan of the Department of Rehabilitation developed a number of cardiovascular rehabilitation training programs based on the patient's condition. Chen Yue’s condition gradually improved: on October 3, she could movearound; on October 9, she was successfully transferred to the general ward of the Cardiac Surgery Department; on November 9, she was discharged from the hospital.
余追介绍，陈月的救治成功，堪称围产期心肌病成功实施机械通气、肾脏替代治疗、ECMO抢救、人工心围术期管理的“天花板”，是全球心血管外科和重症医学临床救治的顶尖水平。
Yu Zhui introduced that Chen Yue's successful treatment can be regarded as the “highest caliber” of a successful implementation of mechanical ventilation, kidney replacement therapy, ECMO rescue, and perioperative management of artificial heart disease in the perinatal period. It is the highest level of cardiovascular surgery and critical care medicine clinical treatment worldwide.
夏军感慨道：“正是有了武汉大学人民医院顶尖救治能力和多学科精诚合作，我们才又一次创造了生命奇迹。”
Xia Jun exclaimed, “The top notch medical expertise of Renmin Hospital of Wuhan University and the sincere cooperation of multiple disciplines are what helped us complete such a miraculous lifesaving surgery once again.”
查房时，陈月对医护人员表示，今年秋天对她有着特殊的意义。这段九死一生的经历，让她更加坚强，更加懂得家人的爱，也更加理解医护工作者的艰辛和伟大。
During the check-in, Chen Yue told the medical staff that this fall has a special meaning for her. The experience has made her stronger, and more aware of her family's love for her. She also has a more deep understanding of the hardship and greatness of healthcare workers.
据统计，我国目前有1370万心衰患者，其中终末期患者超过100万。然而，我国每年心脏移植供体不足1000例，人工心脏的出现为众多终末期心衰患者带来新生的希望。他们或通过人工心脏作为过渡，为心脏移植争取时间，或永久携带人工心脏长期生存。
According to statistics, there are currently 13.7 million heart failure patients in China, of which more than 1 million are end-stage heart failure patients. However, there are only less than 1,000 heart transplant donors in China every year. The emergence of artificial hearts has brought a new hope for life for many end-stage heart failure patients. They either use the artificial heart as a transition to buy time for a heart transplant, or permanently use the artificial heart for survival.
报道链接：
极目新闻：Heroes come from the people：Young Mother with an Artificial Heart Implant is Discharged from Hospit
武汉大学人民医院
湖北省人民医院