体外膜肺氧合技术治疗血行播散性肺结核合并巨细胞病毒性肺炎并发急性呼吸窘迫综合征1例报道  

A case report of extracorporeal membrane oxygenation technique in the treatment of hematogenous disseminated tuberculosis complicated with cytomegalovirus pneumonia and acute respiratory distress syndrome

作　　者：马南兰[1] 茅惠娟 张亚平 陈杰[1] 吴志嵩 韩红洋 MA Nanlan;MAO Huijuan;ZHANG Yaping;CHEN Jie;WU Zhisong;HAN Hongyang(Second Department of Tuberculosis,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Jiangsu Provincial Hospital for Infectious Diseases,Nanjing City Second Hospital in Jiangsu Province,Nanjing City Public Health Medical Center in Jiangsu Province,Nanjing,Jiangsu,211100)

机构地区：[1]南京中医药大学附属南京医院/江苏省传染病医院/江苏省南京市第二医院/江苏省南京市公共卫生医疗中心结核二科,江苏南京211100

出　　处：《实用临床医药杂志》2021年第4期29-33,共5页Journal of Clinical Medicine in Practice

摘　　要：体外膜肺氧合(ECMO)技术主要用于对重症心肺功能衰竭患者提供持续的体外呼吸与循环,以维持患者生命。本研究报告1例13岁男性患儿,诊断为急性血行播散性肺结核合并巨细胞病毒性肺炎,短期内并发急性呼吸窘迫综合征及噬血综合征,氧合指数进行性下降,机械通气治疗无改善,在积极抗结核抗感染抗病毒治疗同时,及时给予ECMO治疗,患儿病情迅速好转,撤离ECMO及呼吸机,病情稳定出院。本例患儿抢救成功的关键是及时采取ECMO支持疗法后采取肺保护通气策略。ECMO作为一种生命支持疗法,可以明显提高抢救成功率,为疾病治疗及肺功能恢复争取时间。Extracorporeal membrane oxygenation(ECMO)technology is mainly used to provide continuous extracorporeal respiration and circulation for patients with severe cardiopulmonary failure so as to maintain the life of patients.This study reported a 13-year-old boy with acute hematogenous disseminated tuberculosis complicated with cytomegalovirus pneumonia.In a short time,he was complicated with acute respiratory distress syndrome and hemophagocytic syndrome.The oxygenation index decreased gradually,but the mechanical ventilation had no improvement in symptoms.After implementation of active anti-tuberculosis,anti-infection,anti-virus and ECMO therapies,the patient′s condition improved rapidly,ECMO and ventilator were removed,and the patient was discharged with stable condition.The key to the successful rescue of this case is to take ECMO support therapy in time and then take lung protection ventilation strategy.As a life support therapy,ECMO can significantly improve the success rate of rescue and gain time for disease treatment and pulmonary function recovery.

关 键 词：体外膜肺氧合技术 血行播散性肺结核 巨细胞病毒性肺炎 急性呼吸窘迫综合征 

分 类 号：R521[医药卫生—内科学] R563.1[医药卫生—临床医学]