三例体外膜肺氧合支持危重症患儿长途转运的护理

Nursing of three children patients receiving extracorporeal membrane oxygenation support during long-distance transfer

目的 总结应用体外膜肺氧合（ECMO）长途转运3例危重症患儿的护理经验.方法 转运前制定完善的预案,以对转运途中可能出现的问题做好应对;转运过程中严密监测患儿的生命体征、ECMO系统的参数及并发症的观察与处理;转运到病房后进行认真交接和后续护理.结果 第1例患儿转运时间为8 h,转运公里为700 km;第2例患儿转运时间为14 h,转运公里数为1200 km;第3例患儿转运时间为15 h,转运公里数为1700 km.成功转运后,2例经治疗顺利出院;第3例为肾病综合征合并卡氏肺囊虫肺炎患儿,在住院期间死亡.结论 ECMO支持患儿长途转运是一个专业化、多学科配合的系统过程,在ECMO辅助下,转运心肺功能衰竭重症患儿是安全可行的,为救治急危重症患者赢得了宝贵的时间.

Objective To summarize the experience of nursing three critical children patients with extracorporeal membrane oxygenation （ECMO） during long-distance transfer. Methods Before the transfer,a sound contingency plan was made in case of problems that might happen during the transfer;during the transfer, the patients＇ vital signs and ECMO parameters were closely monitored,and their complications were identified and managed;when transferred in the ward,they were handed over and nursed carefully. Results The first patient＇s transfer time and distance were 8h and 700km,the second＇s 14 h and 1200 km,and the third＇s 15 h and 1700 km. After successfully transferred,two patients left hospital thanks to treatment,while the other one,who suffered from Nephrotic Syndrome complicated by pneumocystis carinii pneumonia,died in hospital. Conclusions ECMO support for children patients during long-distance transfer is a specialized and systematic process that requires multidisciplinary coordination. The aid of ECMO makes the transfer of severe children patients with Cardiopulmonary Failure possible and safe,and saves valuable time for the treatment of critical patients.