急诊体外膜肺氧合在心脏骤停中的应用研究

目的探讨急诊体外膜肺氧合（extraeorporeal membrane oxygenation，ECMO）在心搏骤停患者中的治疗作用及应用价值。方法2002年6月至2007年7月，应用急诊体外膜肺氧合（ECMO）治疗心搏骤停患者16例，患者男10例，女6例，均采用股动、静脉插管技术，应用离心泵和肝素涂敷管道。ECMO辅助8～73h，平均19h。监测治疗前后动脉血压及血气分析等指标。结果平均动脉压在ECMO后10min比ECMO前明显升高（P〈0．01），ECMO后1h比ECMO后10min有所升高（P〈0.05），CVP在ECMO后10min比ECMO前有所降低，ECMO后1h比ECMO后10min又有所降低（P〈0.05）。经ECMO辅助治疗后低氧血症均迅速改善，动脉血氧分压、血氧饱和度较转流前明显上升（P〈0．05），动脉血乳酸含量明显降低（P〈0．05）。结论ECMO治疗可辅助心脏维持有效的血液循环，明显改善低氧血症，改善机体氧代谢，为大脑提供稳定的氧合血灌流，对心肺复苏有利。

Clinical study of extracorporeal membrane oxygenation for cardiac arrest

Objective To investigate the effects and values of extracorporeal membrane oxygenation (ECMO)in treating patients of cardiac arrest.Methods Between June 2002 and July 2007,16 cases of cardiopulmonary resuscitation were treated by ECMO in our hospital,including male 10 cases,female 6 caseB.Interior iuguhr and femoral intubation were applied to these patients as well as centrifugal pumps and heparin-besmeared conduit.The support time of ECMO was 8 to 73 hours with an average of 19.We closely observed blood pressure and blood oxygen during the whole treatment.Results After ECMO treatment,mean arterial pressure rose 10 min and one hour later,it even got higher(P＜0.05).On the other hand,CVP dropped at once and lower one hour Later(P＜0.05).Besides,hypoxemia improved in a shot time,while arterial partial pressure of oxygen(Pao2).Oxygen saturation of blood increased clearly(P＜0.05),lactive acid of arterial blood decreased significantly(P＜0.05).Conclusion ECMO provides hearts with effective blood circulation,improves hypoxemia and oxygen metabohzation gready.Moreover,it provides brain with stable oxygen-mixed blood thus was good for cardiopulmonary resuscitation.