体外膜肺氧合应用在捐献器官移植中的伦理学意义  

Ethical Significance of Extracorporeal Circulation Membrane Oxygenation Application in Donation Organ Transplantation

作　　者：蓝倩[1] 李壮江[1] 孙煦勇[1] 秦科[1] 董建辉[1] 周洁惠[1] 胡国庆[1] 

机构地区：[1]中国人民解放军第303医院器官移植医学研究院/广州军区肝肾移植中心/广西移植医学重点实验室,广西南宁530021

出　　处：《中国医学伦理学》2015年第5期741-744,共4页Chinese Medical Ethics

基　　金：广西壮族自治区主席资金项目(10169-05);桂科攻0993003A-177

摘　　要：目的探讨体外膜肺氧合(ECMO)在捐献供体器官移植中应用的伦理学意义。方法分析ECMO在13例公民脑死亡后捐献供体器官保护的各项指标数据,核算因ECMO造成的医疗成本升高情况并深入受者家属进行沟通访谈。结果 13例脑死亡(DBD)供者行ECMO转流期间,血流动力学逐步稳定,血管活性药物应用明显减少,甚至停用,受损的器官功能明显恢复,共产出经病理活检证实可用于移植的器官38个,其中肾脏26个、肝脏12个。38例受者肾移植手术均顺利完成。医疗费用总体上升5.3%。供者家属和受者及其家属均能接受ECMO的介入。结论 ECMO的应用能有效保护器官,提高器官利用率。相关技术标准的提高,法律、法规的完善及医护人员伦理道德的提高将会推动ECMO在器官移植应用中的发展。Objective：To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation （ ECMO） in the donation organ transplantation .Methods： Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results：In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion：ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .

关 键 词：体外膜肺氧合 器官移植 器官捐献 医学伦理学 

分 类 号：R-052[医药卫生]