重症单元新型冠状病毒肺炎ECMO综合治疗3例并文献复习  

Literature review of three cases of COVID-19 with ECMO in intensive care unit

作　　者：胡哲夫[1] 周晨亮[1] 严娟娟[1] 孙丽芳[1] 程利 刘玉兰[1] 刘树超[1] 魏捷[1] 王鑫[2] Hu Zhefu;Zhou Chenliang;Yan Juanjuan;Sun Lifang;Cheng Li;Liu Yulan;Liu Shuchao;Wei Jie;Wang Xin(Intensive Care Unit, Renmin Hospital of Wuhan University, Hubei Province Wuhan 430060,China;不详)

机构地区：[1]武汉大学人民医院东院重症医学科,430060 [2]新疆医科大学第一附属医院重症医学科,乌鲁木齐830054

出　　处：《疑难病杂志》2020年第12期1205-1208,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：教育部博士点基金(20130141130010)。

摘　　要：为提高临床医师对ECMO在新型冠状病毒肺炎(COVID-19)救治中的认识,进一步深化ECMO的适应证并提高COVID-19的救治成功率。对3例行ECMO治疗的COVID-19典型病例进行临床分析,并结合文献复习。3例患者入院前均确诊为COVID-19危重型,入院时胸部影像学表现出不同程度的病毒性肺炎典型特征,后病情发展呼吸循环难以维持,均达到ECMO上机适应证。其中2例患者上机后经过综合治疗病情逐渐缓解,最终脱机成功转出ICU;1例病情迅速恶化,并出现呼吸衰竭及多脏器功能障碍而死亡。因此,COVID-19危重患者若发展为呼吸衰竭及多脏器功能障碍,经过恰当的病情评估可使用ECMO,做到及时、精确的经验性治疗可有效改善患者生存率及远期预后。To enhance the knowledge of ECMO and COVID-19 so as to further deepen the indication of ECMO and improve the success treatment proportion of COVID-19 patients.Combined with the literature review,3 cases of COVID-19 patients with ECMO was observed and discussed.Three patients were diagnosed with severe COVID-19 before admission.Chest imaging showed typical characteristics of viral pneumonia in different degrees at admission.With the progress of the disease,it was difficult to maintain the respiratory cycle and reached the ECMO on-board indication.Among them,2 patients got off-line of ECMO and successfully transferred out of ICU after comprehensive treatment;1 patient got worse rapidly and died of respiratory failure and multiple organ dysfunction syndrome.If the critically ill patients of COVID-19 developed into respiratory failure and multiple organ dysfunction syndrome,ECMO can be used after proper condition evaluation.Timely and accurate empirical treatment can effectively improve the survival rate and long-term prognosis of COVID-19 patients.

关 键 词：新型冠状病毒肺炎 体外膜肺氧合 多脏器功能障碍 肺移植 

分 类 号：R47[医药卫生—护理学]