摘要
目的对体外膜氧合(ECMO)技术辅助除肺移植外的非心脏手术(NCPs)患者的临床应用及效果进行总结、分析。方法从中国医师协会体外生命支持分会专业委员会(CSECLS)数据库中收集自2018年1月至2019年10月期间因手术需要或因呼吸、循环状态不稳定或为保证手术安全而接受ECMO辅助的患者资料,对患者的人口统计学、手术类型、ECMO辅助方式、ECMO插管位置、ECMO辅助时间、机械通气时间、住院时间、存活等数据进行总结及分析。结果共采集来自7所医学中心的19例NCPs患者,男性12例,女性7例;年龄29(1~68)岁。接受手术包括胸外科手术6例,气道手术9例,严重创伤后手术3例,妇产科手术1例。ECMO辅助类型包括静脉-动脉ECMO 6例,静脉-静脉ECMO 13例。ECMO辅助时间96(2~471)h,机械通气时间154(12~1344)h,ICU停留时间9(1~58)d,住院时间16(2~58)d,总体存活率84.21%。结论应用ECMO辅助NCPs患者具有良好的临床效果,尤其在胸外科手术及气道手术方面具有广阔的应用前景。对于严重创伤的NCPs患者,在维护好凝血系统及降低抗凝标准后,应用ECMO进行辅助可使更多患者获益。
Objective This study aimed to evaluate the clinical efficacy of extracorporeal membrane oxygenation(ECMO)in non-cardiac procedures(NCPs).Methods This study analyzed data of patients who had ECMO assistance to overcome unstable breathing and circulatory conditions during NCPs from the Chinese Society of Extracorporeal Life Support Association(CSECLS)database between January 2018 and October 2019.Demographics,type of surgery,ECMO-assisted mode,ECMO intubation method,ECMO-assisted time,mechanical ventilation time,length of hospital stay,and survival rate were analyzed and evaluated.Results A total of 19 NCP patients from 7 medical centers were enrolled including 12 males and 7 females and the median age was 9(1-68)years.There were 6 cases of thoracic surgery,9 cases of airway reconstruction surgery,3 cases of severe post-traumatic surgery,and 1 case of obstetrics and gynecology surgery.The ECMO assistance types included 6 cases of V-A ECMO and 13 cases of V-V ECMO.The median ECMO assist time was 96(2-471)hours,the median mechanical ventilation time was 154(12-1344)hours,the median ICU stay time was 9(1-58)days,the median hospital stay time was 16(2-58)days,and the overall survival rate was 84.21%.Conclusion The application of ECMO in NCPs showed good clinical efficacy,especially in thoracic surgery and airway reconstruction surgery.Besides,the application of ECMO could be more beneficial to patients with severely traumatic NCPs when it’s combined with good coagulation system balance and lower anticoagulation criteria.
作者
李双磊
吴扬
任崇雷
王加利
冯泽坤
杜中涛
赖巍
程周
侯晓彤
Li Shuanglei;Wu Yang;Ren Chonglei;Wang Jiali;Feng Zekun;Du Zhongtao;Lai Wei;Cheng Zhou;Hou Xiaotong(Chinese PLA General Hospital First Medical Center,Beijing,100853,China;Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,China;不详)
出处
《中国体外循环杂志》
2019年第6期323-326,共4页
Chinese Journal of Extracorporeal Circulation
关键词
体外膜氧合
非心脏手术
临床效果评价
生命支持
Extracorporeal membrane oxygenation
Non-cardiac procedures
Clinical efficacy evaluation
Life support
