文章摘要
郑翔翔,张石江,梁永年,秦建伟,邵永丰.体外膜肺氧合在心脏术后低心排综合征中的临床应用[J].南京医科大学学报,2015,(12):1743~1745
体外膜肺氧合在心脏术后低心排综合征中的临床应用
Clinical application of extracorporeal membrane oxygenation support for low cardiac output syndrom after heart surgery
投稿时间:2015-07-07  
DOI:10.7655/NYDXBNS20151216
中文关键词: 体外膜肺氧合  低心排综合征  心脏术后
英文关键词: extracorporeal membrane oxygenation  low cardiac output syndrom  post-heart surgery
基金项目:国家自然科学基金资助(81270312)
作者单位
郑翔翔 南京医科大学第一附属医院心胸外科,江苏 南京 210029 
张石江 南京医科大学第一附属医院心胸外科,江苏 南京 210029 
梁永年 南京医科大学第一附属医院心胸外科,江苏 南京 210029 
秦建伟 南京医科大学第一附属医院心胸外科,江苏 南京 210029 
邵永丰 南京医科大学第一附属医院心胸外科,江苏 南京 210029 
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中文摘要:
      目的:总结体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)在心脏术后低心排综合征患者中的临床应用经验。方法:回顾性分析2010年4月—2015年4月,本院23例因心脏术后出现低心排综合征而运用ECMO治疗的临床资料,分析预后及相关影响因素。结果:23例中15例(65.2%)成功脱离ECMO支持治疗,其中10 例存活出院(生存率43.5%),5例成功撤除ECMO后因严重并发症而死亡。8例因无法撤除ECMO而死亡。全组ECMO平均支持时间(191 ± 121)h。ECMO支持治疗期间出现的主要并发症有出血?肺部感染?肾功能衰竭?神经系统并发症等。存活出院组ECMO装机前血乳酸水平及术后总出血量和死亡组比较差异有统计学意义(P < 0.05)。结论:ECMO可为心脏术后低心排患者提供有效的呼吸循环支持,控制术后出血,应用ECMO时机是心脏术后低心排救治成功的关键因素。
英文摘要:
      Objective:To retrospectively summarize the clinic experiene of extracorporeal membrane oxygenation support for low cardiac output syndrom after heart surgery. Methods: From April 2010 to April 2014,23 patients received ECMO support,for the low cardiac output syndrom after heart surgery,were enrolled. The data were retrospectively obtained from our hospital database. Results:Fifteen patients(65.2% )weaned off successfully from ECMO, 10 patients (survival rate 43.5% )were discharged and 5 patients died of post-complications. Eight patients could not wean off from ECMO. Over all mean support time was 191 ± 121 hours. Bleeding,renal failure,lung infection and neurological complication were the most reported complications. The lactate levels before ECM0 support and the amount of blood loss in survivors and nonsurvivors had a significant difference(P < 0.05). Conclusion: ECMO is an effective mechanical assistant therapy method for severe cardiac and pulmonary failure after heart surgery.Earlier usage of ECMO and avoiding massive bleeding are the key point of success of ECMO.
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