应用体外膜式人工肺氧合治疗体外循环脱机困难38例的临床经验

Clinical management of ECMO for patients wean unsuccessfully extracorporeal circulation off in cardiac surgery

目的:总结心脏外科术后脱离体外循环机困难的患者接受体外膜式氧合(ECMO)治疗的临床经验。方法:2004年9月至2010年12月北京安贞医院共38例患者行ECMO治疗,男性29例,女性9例,年龄6个月～74岁,ECMO辅助时间6～280 h,平均65 h。结果:ECMO成功脱机20例(52.6%),其中14例(36.8%)痊愈,6例脱机后死亡;18例未能脱机均死亡。结论:ECMO对于体外循环脱机困难患者是一种有效的辅助措施,及早应用并积极防治ECMO并发症可提高院内生存率。

Objective：To summarize the clinical management of extracorporeal membrane oxygenation（ECMO） for those patients wean unsuccessfully extracorporeal circulation（ECC） off in cardiac surgery.Methods：We reviewed the clinical data of 38 patients underwent ECMO from September 2004 to December 2010 in Anzhen hospital,including 9 females and 29 males aging from 6 months to 74 years old with 65 hours of mean duration of ECMO（6-280 hours）.Results： 20 patients（52.6%） were successfully weaned ECMO off whilst 18 patients failed to wean ECMO off.14 patients（36.8%） were discharged and 24 patients（63.2%） died,in which 6 patients died after weaning ECMO off.Conclusion： ECMO is an efficient supportive therapy for those patients wean unsuccessfully ECC off.We need to prevent any ECMO associated complications during the treatment in order to improve survival rate.