ECMO在氨气中毒致急性呼吸衰竭患者中的应用  

Application of extracorporeal membrane oxygenation technique in patients with acute respiratory failure caused by ammonia poisoning

作　　者：陆欢 刘奇[1] 兰超[1] Lu Huan;Liu Qi;Lan Chao(Emergency Intensive Care Unit,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450018,Henan,China)

机构地区：[1]郑州大学第一附属医院急诊重症监护病区,450018

出　　处：《中华危重病急救医学》2019年第12期1542-1544,共3页Chinese Critical Care Medicine

基　　金：国家自然科学基金(81400051)。

摘　　要：急性重度氨气中毒可严重影响患者氧合功能及通气功能,甚至引起急性呼吸窘迫综合征(ARDS).体外膜肺氧合(ECMO)技术在救治感染所致ARDS、心源性休克、创伤、溺水等患者中的应用越来越多,并取得了一定疗效,但将其用于氨气中毒致ARDS患者的救治鲜见报道.2018年7月7日郑州大学第一附属医院急诊ICU收治1例氨气中毒致ARDS病例,患者入院后在给予抗感染、抗氧化、化痰、雾化等对症治疗基础上,立即给予ECMO治疗,8 d后脱离ECMO,转入普通病房继续康复治疗23 d后病情好转出院,随访至2019年3月未诉不适.总结该病例成功救治的经验,以期为此类患者的救治提供参考.Acute severe ammonia inhalation can seriously affect oxygenation and ventilation function of patients,and even cause acute respiratory distress syndrome(ARDS).Extracorporeal membrane oxygenation(ECMO)technology is increasingly used in treating patients with ARDS caused by infection,cardiogenic shock,trauma,and drowning with achieved certain effects,but its usage for ARDS caused by ammonia is rarely reported.On July 7,2018,a case of ARDS caused by ammonia inhalation was admitted to the emergency ICU of the First Affiliated Hospital of Zhengzhou University.After admission,the patient was treated with ECMO immediately on the basis of anti-infection,anti-oxidation,suctioning and nebulization treatments.After 8 days,he was weaned from ECMO and transferred to a general ward for continued rehabilitation.After 23 days,his condition improved and was discharged without complaining of any discomfort during the follow-up till March 2019.The successful experience was summarized in order to provide reference for the treatment of such patients in the future.

关 键 词：氨气中毒 体外膜肺氧合 急性呼吸窘迫综合征 

分 类 号：R563[医药卫生—呼吸系统]