体外膜肺氧合在循环衰竭中的应用治疗体会

Clinical Application of Extracorporeal Membrane Oxygenation in Patients with Cardiogenic Shock

目的总结循环衰竭患者实施体外膜肺氧合(extracorporeal membrane oxygenation,EC-MO)支持的方法和效果。方法对3例患者实施ECMO支持,年龄17～32岁,体质量45～60 kg。3例患者中,2例为急性暴发性重症心肌炎;另一例为法洛氏四联症矫治术后低心排综合征。采用静脉-动脉转流,辅助流量40～70 ml/(kg.min),间断检测活化凝血时间(activated coagulation time,ACT)150～200 s。结果 ECMO支持时间96～135 h,均成功脱机,康复出院。结论 ECMO支持是抢救危重循环衰竭的有效方法。

Objective To summarize the methods and effects of the extracorporeal membrane oxygenation（ECMO） on severe cardiac disorder patients.Methods The ECMO was performed in 3 patients who aged 17~32 years with body weight 45~60 kg.There were 2 cases of severe myocarditis supported with ECMO after cardiopulmonary resuscitation,and 1 case of Fallot tetralogy supported with ECMO for low cardiac output syndrome after surgical correction.All of them were used vein-artery perfusion,the support perfusion flow varied from 40 to 70ml/（kg·min）.During ECMO,their activated clotting time（ACT） was kept 150～200 seconds.Results The ECMO perfusing time varied from 96 to 135 hours.All patients were succeeded to wean from ECMO and rehabilited and discharged.Conclusion ECMO is an effective emerging approach to manage cadiac function failure and support heart function during cardiosurgery.