体外膜肺氧合在甲型H1N1流感合并ARDS治疗中的应用  

Use of extracorporeal membrane oxygenation for the treatment of the adult respiratory distress syndrome associated with influenza A （H1N1 ） infection

作　　者：吴茜(综述)[1] 吴琦(审校)[1] 孙昕 

机构地区：[1]天津医科大学总医院呼吸科,300052 [2]海河医院呼吸内科,天津300052

出　　处：《中国急救医学》2010年第5期455-458,共4页Chinese Journal of Critical Care Medicine

摘　　要：自2009—03墨西哥、美国首先出现新型甲型H1N1流感后，该疾病迅速在全球蔓延。甲型H1N1流感与季节性流感不同，重症、危重症病例多见于青壮年，易侵犯下呼吸道，导致肺脏的出血、水肿，出现急性呼吸窘迫综合征（ARDS）。机械通气（MV）与体外膜肺氧合（ECMO）均为ARDS呼吸支持的重要救治措施，前者借助患者尚具功能的肺脏作用于外呼吸，部分患者在其治疗下仍存在顽固的低氧血症；后者则通过体外循环系统实现气血交换，直接作用于外周血。达到纠正低氧血症和（或）高碳酸血症的目的，以争取心肺病变治愈及功能恢复的机会。Since March 2009, novel H1N1 influenza appeared in Mexico and the United States, the diseases spread rapidly around the world. Influenza A （H1N1） is different from seasonal influenza, severe and critical illness is prevalent among young adults in particular and easy to violations of the lower respiratory tract, which can cause lung hemorrhage, edema and ARDS. Mechanical ventilation （MV） and extracorporeal membrane oxygenation （ECMO） are important treatments of ARDS respiratory support measures. The former is acting on the external respiration by depending on functional lung. However, with the application of MV, part of the patients still has stubborn hypoxemia. The latter is achieved in blood exchange through the bypass system, directly on the peripheral blood, in order to correct hypoxemia and/or hypercapnia and cure heart, lung lesion and win functional recovery opportunities.

关 键 词：体外膜肺氧合(ECMO) 甲型H1N1流感 急性呼吸窘迫综合征 

分 类 号：R511.7[医药卫生—内科学]