体外膜氧合(ECMO)治疗重症急性呼吸衰竭患者的效果

Effect Observation of Extracorporeal Membrane Oxygenation(ECMO)Treatment on Prognosis of Patients with Severe Acute Respiratory Failure

目的研究重症急性呼吸衰竭(ARF)患者采用体外膜氧合(ECMO)治疗的临床效果。方法将2020年1月—2023年10月两院重症科收治的60例重症ARF患者作为研究对象,均予气管插管有创机械通气治疗,在此基础上,将符合ECMO应用指征而未应用ECMO治疗的30例患者设为对照组,将符合ECMO应用指征且应用ECMO治疗的30例患者设为试验组。比较两组血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))与血氧饱和度(SaO_(2))、氧合指数(氧分压/吸氧浓度,OI)]、急性生理与慢性健康评分表(APACHEⅡ)评分、并发症发生率与临床预后。结果治疗后,试验组PaO_(2)、SaO_(2)和OI均高于对照组,PaCO_(2)水平低于对照组(P<0.05);对照组APACHEⅡ评分高于试验组(P<0.05);试验组并发症发生率低于对照组(P<0.05);对照组撤机成功率和存活率均低于试验组(P>0.05)。结论接受气管插管有创机械通气治疗的重症ARF患者在符合ECMO应用指征的前提下应用ECMO比不应用ECMO取得的效果更好,能改善病情、减少并发症,值得推广。

Objective To investigate clinical effect of extracorporeal membrane oxygenation(ECMO)treatment for patients with severe acute respiratory failure(ARF).Methods The paper chose 60 critically ill ARF patients in ICU department of two hospitals from January 2020 to October 2023 as study subjects,treated with invasive mechanical ventilation through endotracheal intubation.On the basis,30 patients met indications for ECMO without application were included in control group,while 30 patients met indications for ECMO,with application in experimental group.Blood gas indicators PaO_(2),PaCO_(2)and SaO_(2),oxygenation index(oxygen pressure/oxygen concentration,OI),acute physiology and chronic health scores(APACHEⅡ)scores,incidence of complications and clinical prognosis were compared between two groups.Results PaO_(2),SaO_(2),and OI levels in experimental group were higher than control group,while PaCO_(2)level was lower than control group,with significant difference(P<0.05).The APACHEⅡscores of control group were higher than experimental group,difference was significant,(P<0.05).Incidence of complications in experimental group was lower than control group,difference was significant,(P<0.05).Success rate and survival rate of control group was lower than experimental group,there was no significant difference between two groups(P>0.05).Conclusion Application of ECMO can achieve better effect for critically ill ARF patients with invasive mechanical ventilation treatment and endotracheal intubation than without application of ECMO under condition of meeting indications for ECMO application,can improve condition and reduce complications of patients,which is worthy of reference.