体外膜肺氧合在重症患者中的应用36例回顾分析

Retrospective analysis of 36 critical patients treated by extracorporeal menlbrarle oxygenation

目的探讨体外膜肺氧合(ECMO)治疗循环/呼吸衰竭的危重症患者的临床疗效及安全性。方法回顾分析2012年8月至2015年4月郑州大学第二附属医院开展的应用ECMO治疗36例急危重症的循环/呼吸衰竭患者案例,并对其预后、并发症发生率及临床转归的影响因素进行统计分析。结果应用ECMO的患者总体出院生存率50.0%,其中循环支持33.3%,肺支持50.0%,并发症发生率37.8%;ECMO实施前的动脉血乳酸水平对预后的影响差异有统计学意义(P<0.05)。结论 ECMO是一种有效的循环/呼吸衰竭治疗手段,但其临床实施的难度仍较大,并发症较多;合适的时机把握及有效地降低并发症发生率对患者的治疗至关重要。

Objective To investigate the therapeutic effects and safety of extracorporeal menlbrarle oxygenation（ECMO） on critical patients with respiratory or circulatory failure. Methods Medical records of 36 critical patients treated by ECMO from August 2012 to April 2015 in the Second Affiliated Hospital of Zhengzhou University were reviewed; the prognosis,complications and influencing factors were summarized and analyzed. Results Survival rate of patients treated with ECMO in our hospital was 50. 0%,in which circulatory support and respiratory support were33. 3% and 50. 0%,respectively. The incidence rate of complications was 37. 8%. The lactic acid level in arteries blood before ECMO was an influencing factor of prognosis,and had significant statistical difference between survival and dead patients（P 〈 0. 05）. Conclusion ECMO is an effective therapy method for critical patients with respiratory or circulatory failure,but it still has many clinical difficulties and complications. Taking the right time and decreasing the occurrence of complication is important.