体外膜肺氧合治疗重症腺病毒肺炎合并急性呼吸窘迫综合征患儿的护理体会  

Case Report of 20 Cases of ECMO in the Treatment of Severe Adenovirus Pneumonia Complicated with ARDS

作　　者：甘艳如 春晓 马敬香 李甜 梁婉秋 刘恋 Gan Yanru;Chun Xiao;Ma Jingxiang;Li Tian;Liang Wanqiu;Liu Lian(PICU of Guangzhou Children and Women Medical Center,Guangzhou 510623,China)

机构地区：[1]广州市妇女儿童医疗中心PICU,510623

出　　处：《中国实用护理杂志》2020年第11期833-837,共5页Chinese Journal of Practical Nursing

摘　　要：目的总结体外膜肺氧合(ECMO)辅助治疗在重症腺病毒肺炎引起的急性呼吸窘迫综合征(ARDS)患儿中应用的临床护理经验。方法回顾性分析20例重症腺病毒肺炎合并ARDS患儿的临床资料,总结归纳其起病、治疗、并发症及预后等病程中的护理重点。结果20例患儿原发病均为重症腺病毒肺炎,ECMO治疗时长247.50(152.00,296.75)h。治疗后12例(12/20)成功脱离ECMO,存活出院11例(11/20),死亡9例(9/20)。ECMO治疗过程中17例(17/20)患儿出现并发症。出院后随访半年至2年,9例生命质量、社会功能良好,精神运动发育正常;2例因缺血、缺氧脑功能损害,于医院或家庭持续康复锻炼中。结论儿童重症腺病毒肺炎合并ARDS病情危重,当其他治疗手段无效后,ECMO治疗可为可逆性心肺衰竭患儿提供心肺支持治疗,但并发症多且严重,预防和减少相关并发症是ECMO辅助成功的关键。Objective To summarize the clinical nursing experience of oxygenation(ECMO)adjuvant therapy in children with acute respiratory distress syndrome(ARDS)caused by severe adenovirus pneumonia.Method The clinical data of 20 children with severe adenovirus pneumonia complicated with ARDS who received ECMO in our hospital from April 2017 to May 2019,including general conditions,pre-treatment,complications and prognosis,were retrospectively analyzed.Results The primary disease of 20 patients was severe adenovirus pneumonia,and the average duration of ECMO treatment was[247.50(152.00,296.75)]hours.After treatment,12(12/20)patients successfully escaped from ECMO,11(11/20)patients died,and 9(9/20)died.Complications occurred in 17(17/20)patients with ECMO treatment.After discharge from the hospital for six months to two years,9 patients with good quality of life,social function,normal mental development,2 patients with ischemia and hypoxia brain damage,in the hospital or family continued rehabilitation exercise.Conclusions Children with severe adenovirus pneumonia combined with ARDS are critically ill.When other treatments are ineffective,ECMO treatment can provide cardiopulmonary support for children with reversible cardiopulmonary failure,but the complications are numerous and serious.Prevention and reduction of related complications are the key to the success of ECMO.

关 键 词：体外膜肺氧合 重症腺病毒肺炎 儿童 急性呼吸窘迫综合征 

分 类 号：R473[医药卫生—护理学]