体外膜氧合中血小板损伤机制及防治的研究进展  

Research Progress on the Mechanism and Prevention of Thrombocytopenia During Extracorporeal Membrane Oxygenation

作　　者：张艳明 闫姝洁 吉冰洋[1] ZHANG Yanmning;YAN Shujie;JI Bingyang(Deparment of Cardiopulmonary Bypass,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Disease,Finwai Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Bejing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院体外循环中心,北京市100037

出　　处：《中国分子心脏病学杂志》2022年第2期4600-4606,共7页Molecular Cardiology of China

基　　金：阜外医院青年基金(2022-FWQN03)。

摘　　要：体外膜氧合(ECMO)为心肺功能衰竭患者提供心肺支持,是一种挽救危重患者生命的重要辅助支持手段。ECMO系统中非生物材料表面与血液接触后引发的炎性反应、凝血系统紊乱及离心泵产生的高剪切应力会激活血小板,引起血小板数量减少及功能障碍,是出血、血栓、脏器功能损伤、免疫失调等并发症发生的重要原因之一,在一定程度上限制了ECMO的进一步应用。本文归纳了ECMO系统对血小板的影响,总结现有的保护血小板的措施,旨在为临床医生防治ECMO过程中血小板减少和功能障碍提供参考。With the advancement of biomedical technology,extracorporeal membrane oxygenation(ECMO)has been widely used in clinical practice to treat patients with heart or lung failure who are ineffective in conventional treatment,and has become an important auxiliary support to save the lives of critically ill patients.However,the activation of platelets by inflammatory system reactions,coagulation pathway activation and high shear stress generated by centrifugal pumps in contact with non-living materials in the ECMO system activate platelets,causing a decrease in the number of platelets and dysfunction,resulting in complications such as bleeding,thrombosis,organ function damage,immune disorders,etc.limiting the further development of ECMO application.This paper summarizes the effects of the ECMO system on platelets and existing measures to protect platelets,in order to provides a reference for clinicians to prevent thrombocytopenia and dysfunction during ECMO.

关 键 词：体外膜氧合 血小板减少 出血 血栓 血液保护 

分 类 号：R654.1[医药卫生—外科学]