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[体外膜肺氧合在肺动脉内膜剥脱术后肺出血中的应用]

[Use of extracorporeal membrane oxygenation for pulmonary haemorrhage after pulmonary endarterectomy].

作者信息

Edemskiĭ A G, Cherniavskiĭ A M, Kornilov I A, Shmyrev V A, Moroz G B, Deriagin M N, Novikova N V, Zaĭtseva E A, Galstian M G

机构信息

National Medical Research Centre named after Academician E.N. Meshalkin under the RF Ministry of Public Health, Novosibirsk, Russia.

出版信息

Angiol Sosud Khir. 2019;25(4):167-172. doi: 10.33529/ANGIO2019415.

Abstract

Pulmonary haemorrhage is one of the most severe complications of pulmonary endarterectomy. To the most effective methods of combating this potentially fatal complication belongs extracorporeal membrane oxygenation (ECMO). In this article we describe a clinical case report regarding intraoperative use of central veno-arterial ECMO for pulmonary haemorrhage following thromboendarterectomy from the pulmonary arteries. According to the data of some authors, long-term ECMO support (for more than 4 days) may lead to such severe consequences as rethrombosis of pulmonary arteries and impairment of cerebral circulation. In our case we managed to avoid such complications, taking into consideration that the duration of ECMO amounted to 21 days. Resulting from the carried out comprehensive therapeutic measures by the time of discharge from hospital, a significant decrease in pulmonary artery pressure was achieved, with events of residual pulmonary hypertension.

摘要

肺出血是肺动脉内膜剥脱术最严重的并发症之一。体外膜肺氧合(ECMO)是对抗这种潜在致命并发症最有效的方法之一。在本文中,我们描述了一例关于在肺动脉血栓内膜剥脱术后肺出血时术中使用中心静脉 - 动脉ECMO的临床病例报告。根据一些作者的数据,长期ECMO支持(超过4天)可能导致诸如肺动脉再血栓形成和脑循环障碍等严重后果。在我们的病例中,考虑到ECMO持续时间达21天,我们成功避免了此类并发症。由于出院时采取了综合治疗措施,肺动脉压力显著降低,但仍存在残余肺动脉高压情况。

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