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

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65 h。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。

Clinical management of ECMO for patients wean unsuccessfully extracorporeal circulation off in cardiac surgery

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.