应用体外膜式人工肺氧合治疗体外循环脱机困难38例的临床经验

摘要

Objective:To summarize the clinical management of extracorporeal membrane oxygenation ( ECMO) for those patients wean unsuccessfully extracorporeal circulation (ECC) off in cardiac surgery. Methods: We reviewed the clinical data of 38 patients underwent ECMO from September 2004 to December 2010 in Anzhen hospital, including 9 females and 29 males aging from 6 months to 74 years old with 65 hours of mean duration of ECMO (6-280 hours). Results; 20 patients (52.6% ) were successfully weaned ECMO off whilst 18 patients failed to wean ECMO off. 14 patients (36. 8% ) were discharged and 24 patients (63. 2% ) died, in which 6 patients died after weaning ECMO off. Conclusion: ECMO is an efficient supportive therapy for those patients wean unsuccessfully ECC off. We need to prevent any ECMO associated complications during the treatment in order to improve survival rate.%目的:总结心脏外科术后脱离体外循环机困难的患者接受体外膜式氧合(ECMO)治疗的临床经验.方法:2004年9月至2010年12月北京安贞医院共38例患者行ECMO治疗,男性29例,女性9例,年龄6个月～74岁,ECMO辅助时间6～280 h,平均65h.结果:ECMO成功脱机20例(52.6％),其中14例(36.8％)痊愈,6例脱机后死亡；18例未能脱机均死亡.结论:ECMO对于体外循环脱机困难患者是一种有效的辅助措施,及早应用并积极防治ECMO并发症可提高院内生存率.