体外膜肺氧合在慢性血栓栓塞性肺动脉高压患者血栓内膜剥脱术围术期的应用  

Extracorporeal membrane oxygenation application during perioperative period of pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension

作　　者：叶家欣[1] 丁一[1] 陈成[1] 陈涛[1] 陆立冲 葛敏[1] Ye Jiaxin;Ding Yi;Chen Cheng;Chen Tao;Lu Lichong;Ge Min(Department of Cardio-Thoracic Surgery,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院心外重症监护室,南京210008

出　　处：《中华重症医学电子杂志》2018年第3期275-280,共6页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：南京市卫生科技项目医药项目(YKK15071);南京市卫生青年人才计划项目(QRX17131)

摘　　要：目的探讨体外膜肺氧合(ECMO)在慢性血栓栓塞性肺动脉高压(CTEPH)患者血栓内膜剥脱术(PTE)围术期的应用。方法回顾性分析2016年1月至2017年10月于南京大学医学院附属鼓楼医院因PTE术后即出现严重并发症而应用ECMO辅助治疗的患者,均采用静脉-动脉ECMO模式进行辅助。回顾患者临床资料,分析ECMO辅助方式选择,上机指征、过程和辅助效果,以及辅助期间相关并发症等。结果患者均成功拔除气管插管,顺利撤除ECMO辅助,全部存活,康复出院。结论对PTE术后伴有严重并发症的危重症患者,应用静脉-动脉ECMO可以有针对性地缓解并发症,具有非常规治疗可比拟的临床价值。Objective To determine the extracorporeal membrane oxygenation（ECMO） application during perioperative period of pulmonary thromboendarterectomy（PTE） in patients with chronic thromboembolic pulmonary hypertension（CTEPH）. Methods We retrospectively analyzed the data of patients who received venoarterial ECMO after PTE due to serious postoperative complications in Nanjing Drum Tower Hospital from January 2016 to October 2017. The clinical features, basic characteristic, application reason, duration of ECMO and complications were descripted. Results All patients successfully weaned from mechanical ventilation and ECMO, and survived to discharge. Conclusion For critically patients with serious complications after PTE, venoarterial ECMO can be used as an efficient and effective strategy.

关 键 词：体外膜肺氧合 慢性血栓栓塞性肺动脉高压 肺动脉内膜剥脱术 机械通气 

分 类 号：R544.1[医药卫生—心血管疾病]