体外膜肺氧合启动和转运前预测评分系统的研究进展  

The research progresses of the predictive scoring system before ECMO initiation and transportation

作　　者：张敏[1] 周兴梅[1] Zhang Min;Zhou Xing-mei(Shanghai Central Hospital,Shanghai 201620,China)

机构地区：[1]上海市第一人民医院,上海201620

出　　处：《中国急救医学》2019年第7期710-714,共5页Chinese Journal of Critical Care Medicine

基　　金：上海市卫生计生系统重要薄弱学科建设基金项目(2015ZB0304).

摘　　要：体外膜肺氧合(ECMO)是一种针对心脏和肺部的生命支持方式。发达国家已经普遍建立了体外膜肺支持中心,为周边地区提供以转运为渠道的辐射性服务。近年来,ECMO在我国快速发展,也使对一次转运的需求大量增加。一次转运是需要体外膜肺支持的医疗机构或地点(院外或院内)提出申请,ECMO团队会诊,启动ECMO支持,并转运患者回中心。该类患者普遍存在心肺和其他脏器功能受损,内环境不稳;航空和(或)陆地运输,以及多次装载等外环境中存在潜在风险;转运团队配合不良引起人为偏差;体外膜肺技术不可避免的缺陷等因素都有可能导致转运不良事件,以及患者预后不良,医疗成本大幅度升高。因此,专家们开发出ECMO启动和转运前预测评分工具和系统,来对这些患者进行筛选和预评估,使其转运风险最小化,能够优化患者预后。本文将对这些新兴的评分系统做一综述。j Extracorporeal membrane oxygenation ( ECMO) is a cardio respiratory life support. Developed countries have gen erally established an ECMO center and provided radioactive services in the way of transportation for the surrounding areas. In recent years, the rapid development of ECMO in our country has also led to a substantial increase in the demand for primary transportation, which is required that medical institutions or hospitals ( intra 一 hospitals and inter 一 hospitals) with ECMO apply for an ECMO team consultation, initiate ECMO support and transfer patients back to the center. Generally, in such patients, impaired functions of cardiopu 1 monary and other organs, unstable internal environment, potential risks in external environments such as air and / or land transport and multiple loading, man - made bias due to poor coordination of transportation teams, and the inevitable defects in the development of ECMO technology are all likely to lead to adverse events of transportation, poor prognosis in patients, and increasing medical costs significantly. As a result, experts have developed predictive scoring tools and systems to screen and pre - evaluate these patients to minimize the risk of transportation and optimize patients* prognosis. These emerging scoring systems are reported in this article.

关 键 词：体外膜肺氧合(ECMO) 启动 转运 预测评分系统 

分 类 号：R459.7[医药卫生—急诊医学]