体外膜肺氧合在急性心肺功能衰竭患者中的应用与护理  

Nursing care of extracorporeal membrane oxygenation in patients with acute cardiorpulmonary failure

作　　者：宋燕波[1] 曹芳[1] 徐晓红[1] 万里红[1] 姜亚娟[1] 陈华玉[1] 曹权[1] 

机构地区：[1]南京医科大学第一附属医院ICU,210029

出　　处：《江苏医药》2010年第14期1630-1632,共3页Jiangsu Medical Journal

摘　　要：目的探讨心肺功能衰竭患者体外膜肺氧合(ECMO)支持术期间的护理。方法 用ECMO救治心肺功能衰竭患者2例。护理要点:严密监测患者的意识水平、基本生命体征、血流动力学参数、呼吸参数、尿量、末梢循环、脉搏血氧饱和度和血气等;ECMO支持期间,肝素经微量泵静脉泵入,使全血激活凝血时间(ACT)维持在160～200s,注意观察ECMO置管等部位有无出血倾向;选用肺保护性通气策略,加强呼吸道管理;严格执行无菌技术操作,预防导管相关感染。结果 2例患者在使用ECMO后顺利撤机,行ECMO时间分别为6.5d和10.0d。结论在ECMO治疗中,优质护理在预防和及时发现、处理并发症等方面起着关键作用。Objective To summarize the nursing care of extracorporeal membrane oxygenation（ECMO） in patients with cardiopulmonary failure（CPF）.Methods ECMO support was used in two patients with CPF.Intravenous infusion of heparin was given to maintain the activated clotting time（ACT） between 160 and 200 seconds.Intensive nursing care was paied to the close observations of consciousness and basic vital signs,hemodynamic and respiratory parameters,urine output,oxygen saturation,and arterial blood gases.The functions of ECMO device needed to be maintained adequately.Aseptic technique was adopted to prevent catheter-related infections.Results Two patients were weaned from ECMO successfully after 6.5 days and 10.0 days,respectively.ConclusionThe high quality of nursing care during ECMO treatment plays a key role in the prevention and treatment of ECMO-related complications.

关 键 词：体外膜肺氧合 心肺功能衰竭 护理 

分 类 号：R472[医药卫生—护理学]