QA：可以使用的人造器官有哪些？網友回答“舉個例子，拯救心臟病患者的人工心臟 - 左心室輔助裝置”
What are some artificial versions of human organs that can be used?
譯文簡介
它是一個連續(xù)流動的心臟，這意味著，盡管你是直立的、清醒的、說話的、生活的——你將沒有脈搏。
正文翻譯
Dr. Frazier stood holding the still-living man’s heart in his hands.
弗雷澤醫(yī)生站在那里，手里捧著那個仍然活著的人的心臟。
弗雷澤醫(yī)生站在那里，手里捧著那個仍然活著的人的心臟。
With his hands, he softly squeezed the heart over and over again, pumping blood into the man’s body, as he maintained eye contact with the struggling 24-year-old patient.
他輕輕地用手擠壓著心臟，一遍又一遍地將血液泵入患者的身體，同時與這位24歲的患者保持著目光交流。
他輕輕地用手擠壓著心臟，一遍又一遍地將血液泵入患者的身體，同時與這位24歲的患者保持著目光交流。
Their other attempts had failed. There was nothing else the surgeons could do. He was now being kept alive because Dr. Frazier was manually pumping his heart with his hands.
其他的手段都已經失敗了，外科醫(yī)生們已經無能為力。他現在還活著，因為弗雷澤醫(yī)生用手手動地為他的心臟泵血。
其他的手段都已經失敗了，外科醫(yī)生們已經無能為力。他現在還活著，因為弗雷澤醫(yī)生用手手動地為他的心臟泵血。
Dr. Frazier, still a resident, was then told by his supervisor to stop, that nothing else could be done. And ultimately Frazier did, and had to watch as the man’s life left his eyes.
弗雷澤醫(yī)生，當時還只是個住院醫(yī)生，隨后被他的主管告知停止操作，因為已經無藥可救了。最終，弗雷澤不得不看著這個人的生命從他的眼中消逝。
弗雷澤醫(yī)生，當時還只是個住院醫(yī)生，隨后被他的主管告知停止操作，因為已經無藥可救了。最終，弗雷澤不得不看著這個人的生命從他的眼中消逝。
This was the beginning of his journey to an unprecedented invention. Frazier wondered if he could manually pump a man’s heart with his hand, why couldn’t he create a replacement that does the same thing?
這是他邁向一項前所未有的發(fā)明之旅的開始。弗雷澤想知道，如果他能用手手動泵送（泵送血液）一個人的心臟，為什么他不能創(chuàng)造一個能做同樣事情的替代品？
這是他邁向一項前所未有的發(fā)明之旅的開始。弗雷澤想知道，如果他能用手手動泵送（泵送血液）一個人的心臟，為什么他不能創(chuàng)造一個能做同樣事情的替代品？
In the U.S. alone, 5 million people suffer from heart failure. Meanwhile, only 2,000 hearts become available for a heart transplant on a yearly basis.
僅在美國，就有500萬人患有心力衰竭。與此同時，每年只有2000顆心臟可用于心臟移植。
僅在美國，就有500萬人患有心力衰竭。與此同時，每年只有2000顆心臟可用于心臟移植。
Great demand lies in the chasm of this scarcity. That demand is marked by desperation.
巨大的需求隱藏在這個短缺鴻溝中。這種需求充滿了絕望。
巨大的需求隱藏在這個短缺鴻溝中。這種需求充滿了絕望。
Frazier’s first invention was a support to the left valve of the heart, which replaced a failing left valve of the heart, giving strength to a weakened heart.
弗雷澤的第一個發(fā)明是心臟左瓣膜的支架，它取代了心臟衰竭的左瓣膜，為虛弱的心臟提供了力量。
原創(chuàng)翻譯：龍騰網 http://www.top-shui.cn 轉載請注明出處
弗雷澤的第一個發(fā)明是心臟左瓣膜的支架，它取代了心臟衰竭的左瓣膜，為虛弱的心臟提供了力量。
原創(chuàng)翻譯：龍騰網 http://www.top-shui.cn 轉載請注明出處
But his next work, alongside very accomplished and bright people, was the creation of a left ventricular assist device (LVAD) heart. An LVAD heart is artificial:
但他的下一項工作，與非常有成就和聰明的人一起，是創(chuàng)造一個左心室輔助裝置(LVAD)心臟。LVAD心臟是人造的:
但他的下一項工作，與非常有成就和聰明的人一起，是創(chuàng)造一個左心室輔助裝置(LVAD)心臟。LVAD心臟是人造的:
It has been in the development pipeline for years. It has already been used on cows and has once been used to extend the life of an on-death’s-door patient for an additional five weeks.
多年來，它一直處于開發(fā)過程中。它已經被用于奶牛身上，并曾被用來將瀕臨死亡的患者的壽命再延長五周。
This heart could very well be the future of heart transplants, and it may extend your and my life by years when death comes knocking on our door.
這顆心臟很可能成為心臟移植的未來，當死亡來敲我們的門時，它可能會延長你我的壽命。
這顆心臟很可能成為心臟移植的未來，當死亡來敲我們的門時，它可能會延長你我的壽命。
But this heart comes with one spooky twist:
但這顆心有一個令人毛骨悚然的轉折:
但這顆心有一個令人毛骨悚然的轉折:
It is a continuous-flow heart, which means, despite you being upright, awake, talking, living— you will have no pulse.
它是一個連續(xù)流動的心臟，這意味著，盡管你是直立的、清醒的、說話的、生活的——你將沒有脈搏。
它是一個連續(xù)流動的心臟，這意味著，盡管你是直立的、清醒的、說話的、生活的——你將沒有脈搏。
評論翻譯
很贊 ( 1 )
收藏
From my experience at a Cardiac surgery program that put in LVADs, most patients do actually have pulse. It’s just that the pulse isn’t strong enough to keep the patient alive. Most have a blood pressure like 80/70, with the narrow pulse pressure difference being hard to palpate unless you check the femoral artery on a non-obese patient.
Because the heart is still beating you can also get arrhythmias. We used to have monitors go off all the time when the patient’s hearts went into ventricular tachycardia for a minute or two overnight.
從我在心臟手術項目中植入左心室輔助裝置的經驗來看，大多數病人確實有脈搏。只是脈搏不夠強，不足以維持病人的生命。大多數患者的血壓都在80/70左右，除非檢查非肥胖患者的股動脈，否則很難感覺到脈搏壓差很窄。
因為心臟還在跳動，你也可能會有心律失常。我們過去常常關閉監(jiān)測器，當病人的心臟在夜間出現室性心動過速一兩分鐘的時候。
If it is a “continuous flow” heart as mentioned in the answer, would there actually be beats that produce pulses?
如果它是上面提到的“連續(xù)流動”的心臟，那么真的會有產生脈搏的心跳嗎？
It’s attached to the existing heart, which still beats in a weak and often irregular fashion. These beats are often strong enough to be detected, just not strong enough to move the blood around on their own.
This makes sense, as most patients who receive LVADs did not require artificial life support (ECMO, Balloon pump, Impella) in the weeks leading up to their scheduled operations and were being kept alive by their own hearts. This heart activity doesn’t just vanish the moment the LVAD is placed.
它連接在原有的心臟上，原有的心臟仍然會以微弱和經常不規(guī)則的方式跳動。這些跳動通常足夠強大以被檢測到，但不足以單獨推動血液流動。這是有道理的，因為接受左心室輔助裝置植入的大多數患者在手術前的幾周內并不需要人工生命支持（ECMO、氣球泵、Impella），他們是靠自己的心臟維持生命。這種心臟活動不會在植入左心室輔助裝置的那一刻就消失。
How can they created enough place to add that artificial heart next to your heart?
他們是如何創(chuàng)造出足夠的空間在你的心臟旁邊添加人工心臟的?
This was a concern for earlier generation LVADs and both the Heartmate 1 and 2 were actually implanted in the abdomen. As the devices got smaller and switched from inline flow (Heartmate 2) to the more compact centrifugal system used by the Heartmate 3 they were able to fit the system in the thorax without displacing too much lung tissue. A failing heart gets huge as it stretches and fills with fluid, improving flow can create enough space to fit the small teacup sized Heartmate 3.
這是早期左心室輔助裝置的一個問題，Heartmate 1（左心室輔助裝置）和Heartmate 2實際上都是植入腹部的。隨著設備變得越來越小，并從內聯流(Heartmate 2)切換到Heartmate 3使用的更緊湊的離心系統(tǒng)，他們能夠將系統(tǒng)安裝在胸腔中，而不會移位太多的肺組織。衰竭的心臟會隨著拉伸和充滿液體而變得巨大，改善血流可以為小茶杯大小的Heartmate 3創(chuàng)造足夠的空間。
Heartmate 1
Heartmate 2
Heartmate 3
Carl Jacobson
Actually the main problem with these artificial hearts is that they create a massive autoimmune response in the body and are eventually rejected. Even artificial joints have to be redone every 5 years or so, to clean out the decomposed tissue around the artificial joint. The real ‘Big Development’ is stem cell and cloned replacement organs and joints, that the body won’t detect as being a foreign body.
實際上，這些人工心臟的主要問題是它們在體內引起了大規(guī)模的自身免疫反應，最終被排斥。即使是人工關節(jié)每5年左右也必須重新做一次手術，清除人工關節(jié)周圍腐爛的組織。真正的“大進展”是干細胞和克隆替代器官和關節(jié)，身體不會檢測到它們是異物。
I think your assertion that artificial joints have to be redone every 5 years is not true, at least not universally. My father has two artificial hips, one of which is probably about 10 years old already, and his doctors seem to think they should last another 10+ years with no issues. I'm sure autoimmune response is a real problem, and a heart is very different from a hip, but your comment seems to be a bit of an exaggeration.
我認為你所說的人工關節(jié)每5年就必須重新做手術的說法并不正確，至少不是普遍情況。我的父親有兩個人工髖關節(jié)，其中一個可能已經有大約10年了，他的醫(yī)生似乎認為他們再堅持10年以上也沒有問題。我相信自身免疫反應是一個真正的問題，而且心臟與髖關節(jié)非常不同，但是你的評論似乎有點夸張。
You’re correct - 5 years is probably an exaggeration and newer artificial hips may last longer without needing to be cleaned up and replaced.
BUT the fact is that any artificial implant into the human body will cause an auto-immune reaction and gradually kill the tissue around it.
Shoot, I had a root canal fall out several months ago - it was almost 20 years old, but after it fell out I cleaned out the hole with a water pik and it stunk like rotting blood and tissue.
你是對的——5 年可能有點夸張，較新款的人造髖關節(jié)可能會持續(xù)更長時間而無需清理和更換。
但事實是，任何人工植入物進入人體都會引起自身免疫反應，并逐漸殺死周圍的組織。
哎呀，幾個月前我有一個根管脫落——它已經快 20 年了，但在它脫落后我用水槍清理了洞并且它像腐爛的血液和組織那樣發(fā)臭。
"BUT the fact is that any artificial implant into the human body will cause an auto-immune reaction and gradually kill the tissue around it"
Fortunately, that is not the case. Foreign bodies do not cause an auto-immune reaction. Immune (not auto-immune) reactions to stainless steel, titanium, high density polythylene or polymethylmethacrylate are not really an issue. Infection is uncommon but potentially disastrous; mechanical wear and tear as people have joint replacements at a younger age and tend to live longer.
“但事實是，任何人工植入物進入人體都會引起自身免疫反應，并逐漸殺死周圍的組織”
幸運的是，情況并非如此。異物不會引起自身免疫反應。對不銹鋼、鈦、高密度聚乙烯或聚甲基丙烯酸甲酯的免疫(非自身免疫)反應并不是真正的問題。感染并不常見，但可能是災難性的；機械磨損和劣化問題是因為人們在更年輕的時候進行關節(jié)置換，而且活得更久。
原創(chuàng)翻譯：龍騰網 http://www.top-shui.cn 轉載請注明出處
Imagine being the physician for someone with an LVAD heart.
“alright Mr. Smith, time for your annual checkup.”
the doctor checks the patient’s pulse, and is startled to find that there is none.
“That’s odd. You don’t have a pulse… how are you alive again?”
“Oh, that? That’s just the LVAD doing its thing, doc.”
pretty sure the doctor would have a mini heart attack upon finding no pulse!
想象一下，作為帶有左心室輔助裝置的患者的醫(yī)生是什么感覺。
“好的，史密斯先生，你的年度檢查時間到了?！?br /> 醫(yī)生檢查患者的脈搏，驚訝地發(fā)現沒有脈搏。
“這很奇怪，你沒有脈搏……你怎么還活著？”
“哦，那個？那只是左心室輔助裝置在發(fā)揮作用，醫(yī)生?！?br /> 醫(yī)生肯定會因為找不到脈搏而輕微心臟病發(fā)作！
Usually, they know about the heart, and what to expect, as they like to monitor these closely, but there is a story about this from Popular Science circa 2012:
"And here's where the story gets spooky. In November 2003, Frazier installed the newly approved HeartMate II to assist the failing heart of a young man from Central America who barely spoke English. His family members spoke none. So none of them fully understood Frazier's instructions to return to the hospital frequently for follow-up. The young man walked out of the hospital and disappeared.
When he finally showed up eight months later, Frazier held a stethoscope to his chest and was stunned to hear no heartbeat at all. None. Even more-sensitive instruments would have found nothing resembling a pulse. The young man's heart continued to flutter weakly, but it had effectively shut down. Although the HeartMate II had been designed to assist the heart, not replace it, in this case it seemed to be doing all the work: not just helping the left ventricle push oxygenated blood to the body, but pushing the blood hard enough to flow through the body, then back through the useless heart to the lungs, through the useless heart again, and into the pump to complete the loop and begin the process all over again. The reason the young man had never come back for follow-up, he told Frazier, was that he'd felt perfectly fine."
So, there is at least one accidental case!
通常情況下，他們了解LVAD的情況和預期，因為他們喜歡密切監(jiān)視，但Popular Science在2012年有一篇關于這個的報道：
“在這里，故事變得毛骨悚然。2003年11月，弗雷澤為一位來自中美洲、英語幾乎不會說的年輕人安裝了新獲批準的HeartMate 2來幫助衰竭的心臟。他的家人不會說英語。所以他們都沒有完全理解弗雷澤的指示，要經常返回醫(yī)院進行跟進。這位年輕人走出了醫(yī)院，消失了。
八個月后，當他終于出現時，弗雷澤將聽診器放在他的胸前，驚訝地發(fā)現沒有心跳。沒有任何脈搏。即使是更敏感的儀器也無法找到任何類似脈搏的東西。這位年輕人的心臟繼續(xù)微弱地顫動著，但實際上已經停止了。雖然HeartMate 2的設計是為了幫助心臟而不是替代心臟，但在這種情況下，它似乎正在做所有的工作：不僅幫助左心室將含氧血液推向身體，而且還將血液推得足夠強勁，以便經過無用的心臟再次流向肺部，然后再次通過無用的心臟流回泵中完成循環(huán)，并重新開始整個過程。這位年輕人告訴弗雷澤，他沒有回來進行跟進的原因是他感覺很好。”
因此，至少有一個意外的案例！
Er.. vampire?
呃..吸血鬼？
More of a zombie
更像活死人
that’s what i was going t say
這就是我要說的
I was about to suggest that the full-replacement heart have Bluetooth connectivity to let the owner know how well blood was flowing, but then I realized just how bad of an idea that would be in reality.
我本來想建議全面替換的心臟具備藍牙連接，以便讓所有者知道血液流動情況，但后來意識到這在現實中是一個多么糟糕的主意。
So I'll be a living dead. Even though it is a marvelous achievement, but it's spooky as well.
所以我會成為一個活死人。 盡管這是一項了不起的成就，但也令人毛骨悚然。
That would be kinda cool Haha. No pulse. Wonder if it has activity sensors for increasing blood flow during exercise just like a regular heart would beat faster
那會有點酷哈哈。 沒有脈搏。 想知道它是否有活動傳感器來增加運動期間的血流量，就像普通心臟跳動更快一樣
“despite being upright, awake, talking, living— you will have no pulse.”
i can live with that …
“盡管你是直立的、清醒的、說話的、活著的——你還是沒有脈搏。”
我可以忍受這一點 …