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阜外医院99例应用体外膜肺氧合患者的回顾性分析。

Retrospective analysis of 99 patients with the application of extracorporeal membrane oxygenation in Fuwai Hospital.

作者信息

Yuan Yuan, Gao Guodong, Long Cun, Hei Feilong, Li Jingwen, Liu Jinping, Feng Zhengyi, Yu Kun, Zhao Ju, Lrou Shuyi, Hu Shengshou, Chang Qian, Liu Yinglong, Xu Jianping, Wang Xu, Liu Ping

机构信息

Department of Cardiopulmonary Bypass, Peking Union Medical College, Chinese Academy of Medical Science, Fuwai Hospital, Beijing, China.

出版信息

ASAIO J. 2009 Sep-Oct;55(5):474-7. doi: 10.1097/MAT.0b013e3181aed564.

Abstract

The purpose of this study was to retrospectively summarize and analyze the data of 99 cases with the application of consecutive extracorporeal membrane oxygenation (ECMO) from December 2004 to August 2008 in Fuwai Hospital. The intersurface of the ECMO equipment system was completely heparin coated. All patients received venoarterial ECMO, and the activated clotting time was maintained between 120 and 180 seconds. The heparin dose was 5-20 U * kg(-1) * h(-1). Mean blood flow was 40-220 ml * kg(-1) * min(-1) during ECMO assisted period. The shortest ECMO time was 12 hours, and the longest was 504 hours (mean time, 119.45 +/- 80.20 hours). Sixty patients (60.6%) weaned from ECMO successfully; 54 of them (84%) were discharged, and six died of postoperative complications. Thirty-nine patients could not wean from ECMO. Total discharge rate was 54.5%. ECMO is an effective mechanical assistant therapy for cardiac and pulmonary failure after cardiac surgery. Earlier use of ECMO for heart lung failure patients and avoidance of irreversible damage to the main organs are still the key points in the success of ECMO.

摘要

本研究旨在回顾性总结并分析2004年12月至2008年8月期间阜外医院连续应用体外膜肺氧合(ECMO)的99例患者的数据。ECMO设备系统的内表面完全肝素涂层。所有患者均接受静脉-动脉ECMO,活化凝血时间维持在120至180秒之间。肝素剂量为5-20 U·kg⁻¹·h⁻¹。ECMO辅助期间平均血流量为40-220 ml·kg⁻¹·min⁻¹。ECMO最短时间为12小时,最长为504小时(平均时间为119.45±80.20小时)。60例患者(60.6%)成功脱离ECMO;其中54例(84%)出院,6例死于术后并发症。39例患者未能脱离ECMO。总出院率为54.5%。ECMO是心脏手术后心肺功能衰竭的一种有效机械辅助治疗方法。对于心肺功能衰竭患者尽早使用ECMO并避免主要器官发生不可逆损伤仍是ECMO成功的关键要点。

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