院前体外心肺复苏:现状与前景  

Prehospital Extracorporeal Cardiopulmonary Resuscitation in Out⁃of⁃hospital Cardiac Arrest

作　　者：史晓朋 杨蕾[1] 程艳伟 白伟民[1] 景莉娟 秦历杰[1] SHI Xiaopeng;YANG Lei;CHENG Yanwei;BAI Weimin;JING Lijuan;QIN Lijie(Department of Emergency,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院急诊医学部,郑州450003

出　　处：《协和医学杂志》2023年第3期478-483,共6页Medical Journal of Peking Union Medical College Hospital

摘　　要：对于传统心肺复苏不能恢复或维持自主心律的心脏骤停患者,通过建立体外膜肺氧合快速实施体外心肺复苏(extracorporeal cardiopulmonary resuscitation,ECPR)可维持重要器官的血流灌注,提高心肺复苏成功率,改善患者预后。院前实施ECPR可最大化减少心脏骤停患者循环不充分的时间,但因其投入巨大,且受场地条件限制较多,临床推广受到一定限制,因此在团队协作、流程实施及最佳受益人群方面仍有待更深入的研究。目前国内外已有部分医疗机构开展了院前ECPR策略,并取得了一定成效。本文就院前ECPR实施现状及要点进行概述,并对未来应用前景进行展望。Achieving return of spontaneous circulation and improving survival during out⁃of⁃hospital cardiac arrest(OHCA)is challenging.It has been established that extracorporeal cardiopulmonary resusci⁃tation(ECPR)can be an alternative rescue therapy when conventional cardiopulmonary resuscitation(CCPR)fails to re⁃establish circulation.Pre⁃hospital ECPR can reduce the time of inadequate circulation as much as possible.However,the implementation of pre⁃hospital ECPR needs huge investment,and due to the limitations of site conditions,clinical promotion and application are difficult.Therefore,team coop⁃eration,implementation process and the best beneficiaries of the pre⁃hospital ECPR still need further study.At present,some medical institutions at home and abroad have carried out the pre⁃hospital ECPR strategy and achieved some success.Herein,we review the current situation and the prospect of applying prehospital ECPR.

关 键 词：院前急救 体外心肺复苏 体外膜肺氧合 心脏骤停 

分 类 号：R459.7[医药卫生—急诊医学]