2018中国体外生命支持情况调查分析  

China statistics of extracorporeal life support in 2018

作　　者：李呈龙[1] 侯晓彤[1] 黑飞龙[2] 邱海波[3] 李昂 童朝晖[5] 黎毅敏[6] 孙荣青[7] 刘斌[8] 江瑜[1] Li Chenglong;Hou Xiaotong;Hei Feilong;Qiu Haibo;Li Ang;Tong Zhaohui;Li Yimin;Sun Rongqing;Liu Bin;Jiang Yu(Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China;Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210008, China;Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China;department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;Intensive Care Unit, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China;Department of Critical Care Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科危重症中心,北京 100029 [2]中国医学科学院北京协和医学院阜外医院体外循环中心,北京 10003 [3]东南大学附属中大医院重症医学科,南京 210008 [4]首都医科大学附属北京地坛医院重症医学科,北京 100015 [5]首都医科大学附属北京朝阳医院呼吸与危重症医学科,北京 100020 [6]广州医科大学附属第一医院重症监护医学中心,广州 510120 [7]郑州大学第一附属医院重症医学科,郑州 450052 [8]四川大学华西医院麻醉科,成都 610041

出　　处：《中华医学杂志》2019年第24期1911-1915,共5页National Medical Journal of China

基　　金：国家重点研发计划(2016YFC1301001).

摘　　要：目的调查2018年中国体外生命支持开展情况.方法中国医师协会体外生命支持专业委员会于2019年初委托我国33个省市自治区负责人对各地区2018年1月1日至12月31日的体外生命支持数据进行调查,包括各体外生命支持中心的体外膜氧合(ECMO)开展例数、适应证与不同适应证患者的生存率.结果2018年260家医院上报总例数为3 923例,较2017年(2 826例)增加38.8%,开展体外生命支持技术的中心总数较2017年(233家)增加11.6%.ECMO开展人群仍以成人为主,例数占总数的88.0%(3 454/3 923),儿童和新生儿分别占9.7%(380/3 923)和2.3%(89/3 923).年开展20例ECMO以上的中心,其住院生存率高于年开展20例以下的中心(49.1%比44.0%,P=0.005).ECMO例数(r=0.71,P<0.001)、ECMO中心数(r=0.81,P<0.001)均与地区生产总值呈正相关.结论2018年中国体外生命支持例数与中心数较前一年上涨,ECMO中心规模有所扩大,经济发达地区开展的ECMO例数仍占全国例数的绝大部分.我国ECMO适应证比例逐渐与国际接轨,但儿童和新生儿患者比例仍然较低.患者住院生存率与国际水平趋于一致,较大ECMO中心的患者生存率较高.Objective To investigate China statistics of extracorporeal life support (ECLS) in 2018. Methods The statistics data was collected by provincial coordinators assigned by Chinese Society of Extracorporeal Life Support (CSECLS) in 2019, including cases, centers, indications, and in-hospital survival rate. Results Three thousand nine hundred and twenty-three cases were reported by 260 ECLS centers. There were an increase of 38.8% in extracorporeal membrane oxygenation (ECMO) cases and an increase of 11.6% in ECMO centers compared with that in 2017 (2 826 cases and 233 centers). Adult, pediatric, and neonatal patients accounted for 88.0%, 9.7%, and 2.3% of total cases, respectively. Centers with more than 20 ECMO cases per year had favorable in-hospital survival rate compared with those less than 20 cases (49.1% vs 44.0%, P=0.005). ECMO cases (r=0.71, P<0.001) and centers (r=0.81, P<0.001) were both associated with regional gross domestic product. Conclusions There was a growth in ECLS cases, centers, and center scale in China within 2018. The majority of ECLS cases and centers were in developed regions. The ECLS indications, and in?hospital mortality in China were in accordance with that in the Extracorporeal Life Support Organization registry gradually. Large-scale ECLS centers had favorable patient outcomes. The development of ECLS still has tremendous potential in China, especially for pediatric and neonatal patients.

关 键 词：体外膜氧合作用 体外生命支持 数据收集 

分 类 号：R459.7[医药卫生—急诊医学]