高原地区ECMO技术的应用及实践分享

The application and practice sharing of extracorporeal membrane oxygenation technology at high altitude

体外膜肺氧合(ECMO)是具有部分心肺替代功能的体外生命支持技术,在各种需要心肺支持的急危重症患者救治中发挥着越来越重要的作用。青海属于高原地区,全省平均海拔3000 m以上,在低氧、低压的特殊环境下,严重的心肺疾病如重症肺炎、急性呼吸窘迫综合征(ARDS)、高原肺水肿(HAPE)、急性心肌梗死(AMI)及暴发性心肌炎(FM)等疾病的病理生理及临床表现与平原地区不尽相同,救治也有所不同,尤其在新技术的应用及治疗策略上更是如此。青海地区医疗资源和医疗技术相对落后,近几年ECMO技术也有了很大发展,2017年12月至2021年8月在青海省接受ECMO支持治疗的患者共31例。现将青海省ECMO技术的应用情况进行总结,以期ECMO技术在高原地区有更好的应用和发展。

Extracorporeal membrane oxygenation(ECMO)is an extracorporeal life support technology with partial cardiopulmonary replacement function.It plays a more important role in all kinds of critical diseases that need extracorporeal life support.Qinghai belongs to the plateau area,with an average altitude of more than 3000 meters.Under such special environment of hypoxia and low pressure,the pathophysiology and clinical manifestations of serious cardiopulmonary diseases such as respiratory,circulatory failure,acute respiratory distress syndrome,high altitude pulmonary edema,acute myocardial infarction and fulminant myocarditis are different from those in the plain area,so as the treatment.Although medical resources and technology in Qinghai are relatively backward,ECMO technology has made great progress in recent years,and 31 cases have been completed so far.We now summarize the application of ECMO technology in Qinghai Province,so that ECMO technology would had a better application and development in the plateau area.