体外膜肺氧合技术在心肺移植中的应用  

Application of extracorporeal membrane oxygenation in heart and lung transplantation

作　　者：李海斌[1] 石炳毅[1] 张向华[1] 王卓强[1] 陈翔[1] 李红梅[1] 刘京涛[1] 胡晓[1] 

机构地区：[1]解放军第309医院全军器官移植中心心肺移植协作组"器官移植与免疫调节北京市重点实验室",北京100091

出　　处：《军医进修学院学报》2012年第1期9-11,38,共4页Academic Journal of Pla Postgraduate Medical School

基　　金：军队"十一五"科技攻关项目(08G133)~~

摘　　要：目的探讨体外膜肺氧合技术(extracorporeal membrane oxygenation,ECMO)在心、肺移植术的临床应用效果。方法回顾性分析2例心脏移植、1例肺移植、1例肺肾联合移植患者临床资料,对ECMO在心肺移植不同时期的应用效果进行分析。结果 1例肺肾联合移植术前应用ECMO 12d,术中联合应用ECMO与体外循环顺利完成手术,术后间断应用ECMO 17d,择期撤除ECMO。2例心脏移植、1例肺移植术中应用ECMO代替常规体外循环,顺利完成手术。1例肺肾联合移植患者因发生多器官功能衰竭死亡,余3例顺利出院。结论尽早应用ECMO可有效支持心肺功能衰竭患者有效过渡到移植手术;术中应用ECMO代替常规体外循环可满足大部分心脏移植、肺移植手术需要;术后应用ECMO能够为心肺功能衰竭患者提供有效的辅助治疗。Objective To study the clinical application of extracorporeal membrane oxygenation（ECMO） in lung and heart transplantation. Methods Clinical data about 2 cases who underwent heart transplantation, 1 case who underwent lung transplantation and 1 case who underwent lung-kidney transplantation, during which ECMO was applied, were retrospectively analyzed. Clinical effect of ECMO on patients during lung and heart transplantation was analyzed. Results The ECMO was applied for 12 days before lung-kidney transplantation and for 17 days after the operation in 1 case. It was applied, instead of routine extracorporeal circulation, in 2 cases during heart transplantation and 1 case during lung transplantation. One patient died of multiple organ failure after lung- kidney transplantation while the other 3 cases were discharged after they recovered. Conclusion Early application of ECMO can effectively help patients with heart and lung failure during heart and lung transplantation. ECMO, instead of routine extracorporeal circulation, can meet the needs of most patients during heart and lung transplantation, and can be used as an effective adjuvant therapy for those with heart and lung failure.

关 键 词：体外膜肺氧合 心脏移植 肺移植 肺肾联合移植 体外循环 

分 类 号：R617[医药卫生—外科学]