ECMO在严重胸外伤抢救中的应用研究并2例病例报告

目的：探讨体外膜肺氧合在严重胸外伤抢救中的应用。方法：将我院2016年1月至2016年2月收治的严重胸外伤2例作为研究对象，两例患者均采用穿刺置管，由颈内静脉及股静脉置管，接MAQUET离心泵血液灌注系统(体外膜肺氧合) v一v模式治疗，对两例患者治疗前后血流动力学以及氧代谢指标进行监测。结果：与治疗前相比，经过体外膜肺氧合之后，患者混合静脉血分压、静脉血氧饱和度、动脉血氧分压、血氧饱和度明显改善，氧供与氧耗也明显增加，患者经过治疗后动脉血乳酸含量明显低于治疗前，氧摄取率也明显高于治疗前，经分析，数据差异明显，具有统计学意义（P<0.05）。在体外膜肺氧合前后，患者血流动力学无明显变化（P>0.05）。结论：对于胸外伤抢救患者采用体外膜肺氧合进行治疗，能够有效的降低氧血症的发生，对机体的氧代谢进行改善，提高组织的氧摄取率，从而赢得了治疗原发病的时间，有利于胸外伤的抢救。

Application of ECMO in the treatment of severe thoracic trauma and report of 2 casesWen Weibiao,Zhou Lixin,Fang Bin,Qiang Xinhua

Objective: To explore the application of extracorporeal membrane oxygenation in the treatment of severe thoracic trauma. Methods: Twenty patients with severe thoracic trauma admitted in our hospital from January 2016 to February 2016 were selected as the subjects. Two patients were treated with puncture catheter, and the internal jugular vein and femoral vein were placed. Then, MAQUET was centrifuged Pump blood perfusion system (in vitro membrane lung oxygenation) v-v mode of treatment, two patients before and after treatment hemodynamics and oxygen metabolism indicators Jinxin that monitoring. Results: Compared with before treatment, after intravenous oxygenation, the patients were mixed with venous blood pressure, venous oxygen saturation, arterial oxygen pressure, oxygen saturation significantly improved oxygen supply and oxygen consumption was significantly increased, After treatment, the blood lactic acid content of the patients was significantly lower than before treatment, oxygen uptake rate was significantly higher than before treatment, the analysis, the data were significantly different, statistically significant (P <0.05). There was no significant change in hemodynamics before and after pulmonary vascular anesthesia (P> 0.05). Conclusion: The treatment of thoracic trauma patients with extracorporeal membrane oxygenation can effectively reduce hypoxemia, improve the oxygen metabolism of the body, improve the oxygen uptake rate of the tissue, and thus win the time of treatment of primary disease. Conducive to chest trauma rescue, it is worth in the clinical process to promote the application.