体外辅助器械在暴发性心肌炎患者治疗中的应用价值

Application value of extracorporeal auxiliary instruments in treatment of patients with fulminant myocarditis

目的分析暴发性心肌炎(FM)的临床特点,总结体外辅助机械治疗FM的效果。方法选取中国人民解放军空军军医大学第二附属医院(唐都医院)2018年1月—2020年12月收治的急性FM患者7例,总结FM的临床特点和治疗方法。结果7例急性FM患者中,6例使用了辅助器械,包括体外膜肺氧合(ECMO)、临时起搏器、连续性肾脏替代治疗(CRRT)、主动脉内球囊反搏泵(IABP)。5例患者治疗后好转出院,1例患者死亡,1例患者自愿放弃治疗。结论FM具有起病急、进展迅速等特点,快速及正确的诊断和治疗非常关键,早期给予ECMO治疗较为有效。

Objective To analyze the clinical features of fulminant myocarditis(FM) and summarize the effect of extracorporeal auxiliary instruments in treating FM. Methods Seven patients with acute FM treated the Second Affiliated Hospital of Air Force Medical University of the Chinese People′s Liberation Army(Tangdu Hospital) from January 2018 to December 2020 were selected, and the clinical features and therapeutic methods of FM were summarized. Results Among the 7 patients with acute FM, 6 patients used auxiliary instruments, including extracorporeal membrane oxygenation(ECMO), temporary pacemaker, continuous renal replacement therapy(CRRT) and intra-aortic balloon pump(IABP). Five patients became better and discharged after treatment, one patient died and one patient voluntarily gave up treatment. Conclusion FM has the characteristics of acute onset and rapid progress, rapid and correct diagnosis and treatment are very important, and early ECMO treatment is effective.