2019年河北省体外膜肺氧合开展情况调查分析

Investigation and analysis of the development status of extracorporeal membrane oxygenation in Hebei province in 2019

目的调查2019年河北省体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)开展情况。方法河北省急诊质控中心于2020年初委托河北省11个地级市急诊质控中心负责人对各地区2019年1月1日至12月31日的ECMO开展情况进行调查分析。结果2019年8家医院上报总例数为65例,较2018年(25例)增加40例,开展ECMO的中心数为8家。ECMO开展人群仍以成人为主,例数占98.5%(64/65),儿童例数占1.5%(1/65),新生儿未开展。2019年开展15例以上的ECMO中心仅一家,其余7家年开展例数均小于6例。河北省ECMO患者成人呼吸辅助的ECMO患者生存率为50%(7/14),成人心脏辅助的ECMO患者生存率为41.7%(15/36),体外心肺复苏(ECPR)生存率为0(0/14),儿童心脏辅助的ECMO患者生存率为100%(1/1)。结论2019年河北省ECMO开展中心数及总例数均较2018年有所升高,但ECMO开展情况与全国其他地区比较,开展中心数及例数较少,各地区发展不均衡,儿童仅开展1例,新生儿未开展。患者住院生存率偏低,尤其是ECPR。今后将通过建立区域性的ECMO中心、组建三级医院协作的ECMO救治网络、建立ECMO培训基地等多种措施推动ECMO技术发展。

Objective To investigate the development status of extracorporeal membrane oxygenation(ECMO)in Hebei province in 2019.Methods In early 2020,the Hebei Emergency Quality Control Center commissioned the persons in charge of emergency quality control centers in 11 prefecture level cities in Hebei province to investigate and analyze the development status of extracorporeal membrane oxygenation(ECMO)in Hebei province from January 1,2019 to December 31,2019.Results The total case numbers reported in eight hospitals in 2019 were 65 cases,with an increase of 40 cases,as compared with those(25 cases)in 2018,and the numbers of centers that developed ECMO were 8.The population of ECMO development was still dominated by adults,which accounted for 98.5(64/65),and 1.5%of cases were children(1/65),which was not developed in neonates.There was only one ECMO center with more than 15 cases in 2019,and the rest 7 centers had fewer than six cases.The survival rate of adult respiratory-assisted ECMO patients in Hebei province was 50%(7/14),and that of adult cardiac-assisted ECMO patients was 41.7%(15/36),the survival rate of extracorporeal cardiopulmonary resuscitation(ECPR)was 0(0/14),and that of children with cardiac-assisted ECMO was 100%(1/1).Conclusion In 2019,the number of ECMO centers and the total number of cases in Hebei province are increased,as compared with those in 2018,however,as compared with the cases in the other regions in our country,the number of centers and cases of ECMO development are relatively fewer,and uneven development in different regions,with only one case of children and no newnates.Moreover the hospitalization survival rate is lower,especially for ECPR.In the future,it is necessary to establish regional ECMO centers and ECMO treatment network coordinated by tertiary hospitals,so as to promote the development of ECMO technique.