重视体外膜肺氧合在严重心肺创伤救治中的作用  

Attach great importance to the role of extracorporeal membrane oxygenation in the rescue of severe cardiopulmonary trauma

作　　者：易云峰 Yi Yunfeng(Department of Cardiothoracic Surgery,909th Hospital of Joint Logistics Support Force(Affiliated Dongnan Hospital of Xiamen University Medical College),Cardiothoracic Surgery Medical Center of Eastern War Zone,Zhangzhou363000,China)

机构地区：[1]联勤保障部队第九○九医院(厦门大学医学院附属东南医院)心胸外科,东部战区心胸外科医学中心,漳州363000

出　　处：《中华创伤杂志》2022年第11期973-976,共4页Chinese Journal of Trauma

基　　金：全军后勤科研项目(CWH17J030,CNJ14C007);军队高层次科技创新人才工程人选自主科研项目(联战(2022)151)。

摘　　要：严重心肺创伤早期的救治原则是纠正呼吸和循环功能不全。而各类创伤所致的重度肺泡血氧交换功能障碍、肺内大出血、肺大面积不张及心内膜下广泛出血等严重心肺创伤,常规治疗效果不佳,及时运用体外膜肺氧合(ECMO)的心肺替代功能可较好地克服这个难题。ECMO是为严重心肺功能不全患者提供生命支持技术,能较长时间部分代替心脏泵血和肺氧合功能,为等待脏器功能恢复和提供桥接治疗等创造机会。笔者对ECMO的作用机制与临床应用,ECMO在严重心肺创伤中的应用、不足及对策进行探讨,为提升ECMO的救治质量和流程提供一定理论和实践参考。The principle of early treatment for severe cardiopulmonary trauma is to correct respiratory and circulatory insufficiency,especially for the type of injury caused by various types of trauma such as severe alveolar oxygen exchange dysfunction,intrapulmonary hemorrhage,massive pulmonary atelectasis and extensive subendocardial hemorrhage.Conventional treatment is not effective,and the timely use of cardiopulmonary replacement function of extracorporeal membrane oxygenation(ECMO)can better overcome this problem.ECMO is a life-support technology for patients with severe cardiopulmonary insufficiency,which can partially replace the functions of heart pumping and lung oxygenation for a longer period of time so as to creat opportunities for waiting for organ function recovery and providing bridging therapy.The author discusses the mechanism of action and clinical application of ECMO and the application,deficiencies and countermeasures of ECMO in severe cardiopulmonary trauma so as to provide some theoretical and practical references for improving the quality and process of ECMO treatment.

关 键 词：胸部损伤 体外膜氧合作用 心肺创伤 

分 类 号：R655[医药卫生—外科学]