体外膜肺氧合用于急危重症患者的临床观察

The clinical indications for Extrocopereal membrane oxygenation in acute and sever cases.

目的总结8例危重心肺疾病患者实施体外膜肺氧舍（ECMO）的方法和效果，对实施病例的适应证、时机及结局进行回顾性分析，为危重患者ECMO的支持适应证及时机选择提供一些可靠经验。方法对8例不同病因及不同时机患者实施ECMO，年龄26—82岁，体重57～87kg，采用静脉．动脉转流，辅助流量40～70ml／（kg·min）；ACT160—200s。并对8例患者支持适应证、时机选择及结局进行总结分析。结果ECMO时间9．5—84．1h。1例未能脱机死亡；2例脱机后38、6h后死亡；5例成功脱机，康复出院。结论ECMO是抢救危重心肺功能衰竭、复苏中支持及心脏手术心功能支持的有效方法，其适应证及时机的选择对实施结局有重要影响。

Objective To summarize the method and effects of extracorporeal membrane oxygenation （EC- MO） for eight patients with sever heart or（and） lung diseases, and to get some reliable advises by analysis of retrospective indications, timing and result in ECMO therapy. Methods Eight patients, aging from 26 to 82 and weighted from 57 -87 kg were observed. Vein-artery ECMO was used in all patients,with the flow in 40 -70 ml/（ kg·min） and the activated clotting time（ACT） kept at 160 - 200 s. Results The time of ECMO support varied from 9.5 h to 84.1 h;Among the eight patients,one didn＇t weaned from ECMO and died,two who were weaned died 38 h ,6 h after ECMO;five patients weanned succsesefully from ECMO and discharged. Conclusions ECMO do well in treatment of severe cardiopulmonary failure, resuscitation and support post cardiosurgery, and the indication and timing performance are important to the final result.