体外膜肺氧合应用于心脏术后呼吸循环衰竭患者的护理

Nursing of the Application of Extracorporeal Membrane Oxygenation in Patients with Post Cardiac Surgery Respiratory Circulatory Failure

目的探讨体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)应用于心脏术后呼吸循环衰竭患者的护理方法。方法回顾性分析并总结2014年6月至2015年12月南京大学医学院附属鼓楼医院心胸外科应用ECMO救治的10例心脏术后呼吸循环衰竭患者的临床资料。结果本组10例患者均顺利停机并撤除ECMO,其中5例患者治愈出院,2例患者因经济问题放弃治疗,2例患者死于多器官功能衰竭综合征(multiple organ disfunction syndrome,MODS),1例撤机后死于严重心力衰竭。结论合适的应用时机、严密的监测和观察、专业的ECMO管理、精细的护理支持,是心脏术后呼吸循环衰竭应用ECMO患者康复的保证。

Objective To discuss the nursing method of the application of extracorporeal membrane oxy-genation in patients with post cardiac surgery respiratory circulatory failure.Methods Clinical data of 10 patients with postoperative respiratory circulatory failure and applied with effectively ECMO intervention from June 2014 to December 2015 were analyzed retrospectively.Results Ten patients were both halted and removed the ECMO.Among them,5 cases were cured and discharged from hospital,2 patients were given up treatment because of economic problems,other 2 patients died of multiple organ dysfunction syn-dromes（MODS）and 1 case died of severe heart failure after removal of the machine.Conclusions The ap-propriate ECMO application timing,close monitoring and observation,professional management of ECMO and careful nursing support are the keys to the success of ECMO.