体外膜肺氧合在失血性心脏骤停中的应用

摘要

目的 探讨体外膜肺氧合(ECMO)在失血性心脏骤停中应用的价值.方法 回顾性分析我院20例因失血性休克致心脏骤停行ECMO治疗的患者.监测ECMO治疗前、ECMO治疗后10 min,原发病解决后ECMO治疗1h、6h、12h、24 h的心率、平均动脉压、中心静脉压(CVP)；并抽取桡动脉血检测动脉血氧分压、动脉血乳酸含量.并且统计辅助时间.结果 平均动脉压在ECMO治疗后10 min比ECMO治疗前明显升高(P＜0.05),原发病解决后ECMO治疗1h比ECMO治疗后10min有明显升高(P＜0.05)；CVP在ECMO治疗后10min比ECMO治疗前显著降低(P＜0.05),ECMO治疗后1h比ECMO治疗后10 min显著升高(P＜0.05)；经ECMO治疗后10min动脉血氧分压较ECMO治疗前明显上升(P＜0.05),动脉血乳酸含量明显降低(P＜0.05),平均辅助时间(23.5±7.1)h.结论 失血性心脏骤停行ECMO治疗的辅助时间短,心功能恢复快,成功率高,ECMO在失血性心脏骤停中应用是可行的.%Objective To investigate the value of the application of extracorporeal membrane oxygenation in patients with hemorrhagic cardiac arrest Methods 20 cases with hcmorrhagic shock cardiac arrest patients who has been treated with ECMO were nalyzed retrospectively. The heart rate, mean arterial pressure, and central venous pressure (CVP) were monitored at various time points.The point of before ECMO treatment, the ECMO treatment after 10 min , ECMO treatment after solving original disease for 1 h, 6 h, 12 h, 24 h . Detect the arterial partial pressure of oxygen and blood lactic acid content Results The MAP of the point of the ECMO treatment afterlO min was increased more significantly than that of before ECMO treatment (P<0.05), the MAP of the point of the ECMO treatment after solving original disease for 1 h increased more significantly than that of the ECMO treatment after 10 min (P<0.05); the CVP of the point of the ECMO treatment afterlO min was reduced more than before ECMO treatment, and ECMO treatment after solving original disease for 1 h more significantly than that of the ECMO treatment after 10 min (P<0.05). The PaO2 of the point of the ECMO treatment after10 min was increased much more significantly than that of before ECMO treatment (P <0.05), and blood lactic acid reduced more obviously (P<0.05). The auxiliary time of ECMO was (23.5±7.1) h. Conclusion The time of the application of extracorporeal membrane oxygenation in hemorrhagic cardiac arrest patients is shortter, their heart function restore faster, and success rate is high. The application of extracorporeal membrane oxygenation in hemorrhagic cardiac arrest patients is feasible.