静脉-静脉转流的体外膜肺氧合模式联合主动脉内球囊反搏术抢救多支冠状动脉完全闭塞合并急性重症肺水肿一例报道

Rescue of Multiple Coronary Total Occlusion with Acute Severe Pulmonary Edema by Veno-Venous ECMO Combined with IABP:a Case Report

多支冠状动脉完全闭塞(MTO)指2支及以上冠状动脉血管狭窄率均接近或达到100%,TIMI 0~1级,具有发病急、进展快、病情重、并发症多等特点,常因抢救不及时而危及生命,而根据患者病情变化选择合适的治疗方案是救治成功的关键,但相关研究报道较少。本文报道1例通过静脉-静脉转流的体外膜肺氧合(V-V ECMO)模式联合主动脉内球囊反搏术(IABP)成功救治的MTO合并急性重症肺水肿患者的诊疗过程及治疗方案,以期为提高MTO合并急性重症肺水肿患者的临床救治水平提供参考。

Multiple coronary total occlusion(MTO)refers to the stenosis of two or more coronary arteries reaching or approaching 100%(TIMI blood flow grade 0-1),which is characterized by unexpected onset,rapid progress,severe state and many severe complications,and often endangers the life of patients due to belated rescue.Choosing an appropriate treatment plan according to the changes of the disease condition is the key to successful treatment,but there are few relevant reports in the review.This article reported the treatment plan and experience of a patient with MTO complicated with acute severe pulmonary edema successfully treated by V-V ECMO combined with IABP,in order to provide reference for improving the clinical rescue effect of patients with MTO complicated with acute severe pulmonary edema.