体外膜肺氧合患者下肢缺血性损伤的影响因素研究

Influencing factors of lower extremity ischemic injury in patients with extracorporeal membrane oxygenation

目的探讨体外膜肺氧合(ECMO)患者下肢缺血性损伤的影响因素。方法采用便利抽样法,选取2016年7月—2020年12月浙江大学医学院附属杭州市第一人民医院重症医学科收治的123例ECMO患者为研究对象,以是否发生下肢缺血为分组依据,将发生下肢缺血的患者纳入缺血损伤组(n=21),未发生下肢缺血的患者纳入无缺血损伤组(n=102)。收集两组患者临床资料,采用多因素Logistic回归分析ECMO患者下肢缺血的影响因素。结果多因素Logistic回归分析结果显示,糖尿病、心脏骤停、左心室射血分数、ECMO辅助时间均是ECMO患者下肢缺血的影响因素(P<0.05)。结论ECMO患者下肢缺血的发生与糖尿病、左心室射血分数等因素相关,需要医护人员予以高度重视,采取措施积极进行防治。

Objective To explore the influencing factors of lower extremity ischemic injury in patients with extracorporeal membrane oxygenation(ECMO).Methods From July 2016 to December 2020,convenience sampling was used to select 123 ECMO patients admitted to the Intensive Care Unit,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine as the research object.Based on the occurrence of lower extremity ischemia,the patients with lower extremity ischemia were included in the ischemic injury group(n=21),and the patients without lower extremity ischemia were included in the non-ischemic injury group(n=102).The clinical data of the two groups of patients were collected,and the influencing factors of lower extremity ischemia in ECMO patients were analyzed by multivariate Logistic regression.Results Multivariate Logistic regression analysis showed that diabetes,cardiac arrest,left ventricular ejection fraction,and ECMO adjuvant time were all influencing factors for lower extremity ischemia in ECMO patients,and the differences were statistically significant(P<0.05).Conclusions The occurrence of lower extremity ischemia in ECMO patients is related to factors such as diabetes mellitus and left ventricular ejection fraction,which needs medical and nursing staff to attach great importance to it and take measures to actively prevent it.