体外膜肺氧合在气道重建手术中的应用  

Application of extracorporeal membrane oxygenation in airway reconstruction surgery

作　　者：付国伟[1] 李军[1] 赵俊杰[1] 阚亚柏 刘闯[1] 王振卿[1] 赵阳超[1] FU Guowei;LI Jun;ZHAO Junjie;KAN Yabai;LIU Chuang;WANG Zhenqing;ZHAO Yangchao(Department of Extracorporeal Life Support Center,First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China)

机构地区：[1]郑州大学第一附属医院体外支持中心,450000

出　　处：《心肺血管病杂志》2022年第12期1263-1266,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:总结分析体外膜肺氧合(ECMO)在气道重建术中应用的可行性及安全性。方法:收集郑州大学第一附属医院体外生命支持中心2018年1月至2021年12月,ECMO辅助气道重建术患者共11例,采集患者的信息,并对患者的人口统计学、ECMO辅助方式、ECMO插管位置、ECMO辅助时间、术后机械通气时间、ICU停留时间、在院时间、并发症等数据进行总结及分析。结果:使用ECMO辅助气道重建术患者共11例,男性8例(72.7%),年龄42岁(22d,72岁)。静脉到静脉ECMO(VVECMO)9例(81.8%),中心插管静脉到动脉ECTO(VAECMO)1例(9.1%),外周VAECMO1例(9.1%)。ECMO辅助时间160(42,1560)min,术后机械通气时间42(0.75,190)h,ICU停留时间5(0,37)d,在院时间21(9,39)d。所有患者均顺利撤除ECMO并存活出院。结论:因气道肿瘤、气管断裂等需要气道重建的患者,术中短期使用ECMO辅助是安全可行的。对于低体质量患儿的气道手术进行术中辅助时,可选择中心插管VAECMO,既能有效预防手术过程中指脉氧饱和度下降的情况,也能避免颈动脉插管的损伤。Objective:To summarize and analyze the feasibility and safety of extracorporeal membrane oxygenation(ECMO)in airway reconstruction.Methods:A total of 11 patients with extracorporeal oxygenation membrane lung-assisted airway reconstruction in the Extracorporeal Life Support Center of the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2021 were collected.Demographics,ECMO-assisted mode,ECMO intubation method,ECMO-assisted time,postoperative mechanical ventilation time,length of ICU stay,length of hospital stay,complications and other data were summarized and analyzed.Results:The Extracorporeal Life Support Center of the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2021 used ECMO to assist airway reconstruction in a total of 11 patients,including 8 males(72.7%)and an age of 42(22,72)years.9 cases(81.8%)were VVECMO,1 case(9.1%)was center VAECMO,and 1 case(9.1%)was peripheral VAECMO.ECMO-assisted time was 160(42,1560)minutes,postoperative mechanical ventilation time was 42(0.75,190)hours,length of ICU stay was 5(0,37)days,and length of hospital stay was 21(9,39)days.All patients were successfully withdrawn from ECMO and survived to discharge.Conclusions:For patients who need airway reconstruction due to airway tumors,tracheal rupture,etc.,short-term use of ECMO during surgery is safe and feasible.For the intraoperative assistance of airway surgery in low-weight children,central intubation VAECMO can be selected,which can not only effectively prevent the decrease of finger pulse oxygen saturation during the operation,but also avoid the injury of carotid artery intubation.

关 键 词：体外膜肺氧合 气管断裂 气管肿物 气道重建 低体质量患儿 

分 类 号：R54[医药卫生—心血管疾病]