体外膜肺氧合在严重肺挫伤中的应用

目的 探讨体外膜肺氧合（ECMO）对严重肺挫伤患者的治疗效果及应用价值。方法 应用ECMO治疗严重肺挫伤患者17例，均采用颈内静脉、股静脉插管技术，应用离心泵和肝素涂敷管道。ECMO辅助27-94h，平均62h。监测治疗前后血流动力学及氧代谢指标。结果 行ECMO治疗后，静脉血氧分压、静脉血氧饱和度、动脉血氧分压、血氧饱和度明显上升（P〈0．01）；氧供明显增加，氧耗也随之有所增加（P〈0．05）；动脉血乳酸含量明显降低（P〈0．01）；氧摄取率有所上升（P〈0．05）。ECMO前后血流动力学无明显变化。结论 ECMO治疗能明显改善低氧血症，从而改善机体氧代谢，提高组织氧摄取率，为治疗原发病赢得时间。

Extracorporeal membrane oxygenation in severe pulmonary contusion

Objective To investigate the therapeutic effect and application value of extracorporeal membrane oxygenation (ECMO) in severe pulmonary contusion.Methods In treating 17 severe lung contusion patients by ECMO,internal jugular vein and femoral vein catheter were adopted and the tube was rubbed with centrifugation pump and heparin.The support time of ECMO was 27 94 hours,averaging 62h.Hemodynamics and oxygenation were monitored before and after treatment.Results After treatment,mixed venous partial pressure of oxygen,venous oxygen saturation,arterial partial pressure of oxygen and oxygen saturation increased remarkably (P<0.01).Oxygen supply increased and oxygen exhaust increased consequently (P<0.05),but blood lactate concentration decreased significantly (P<0.01) and oxygen intake elevated (P<0.05).Hemodynamic did not change after treatment.Conclusion ECMO treatment improves the hypoxemia,contributing to the improved oxygenation and the increased rate of oxygen intake,winning time for the treatment of primary disease.