肺移植围术期ECMO应用经验分析  

Experience analysis of perioperative ECMO application in lung transplantation

作　　者：王泓懿 李益行 高山[1] 林婷[2] 高洁[2] 王绩钊 赵睿 郭锋伟[3] 李硕[1] 张广健[1] Wang Hongyi;Li Yixing;Gao Shan;Lin ting;Gao jie;Wang Jizhao;Zhao Rui;Guo fengwei;Li Shuo;Zhang Guangjian(Department of Thoracic Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China;Department of Surgical ICU,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China;Department of Cardiac surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院胸外科,陕西西安710061 [2]西安交通大学第一附属医院外科ICU,陕西西安710061 [3]西安交通大学第一附属医院心外科,陕西西安710061

出　　处：《实用器官移植电子杂志》2023年第3期237-241,共5页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：陕西省重点研发计划(2020SF-101)。

摘　　要：目的总结9例肺移植围术期ECMO应用经验和管理要点。方法收集自2022年10月以来就诊于西安交通大学第一附属医院胸外科的ECMO辅助肺移植患者资料,回顾性分析其临床特点及管理经验。结果9例患者中6例行VA-ECMO,2例行VV-ECMO,1例行VAV-ECMO。VA插管方式均为腋动脉-股静脉法,VV插管方式为股静脉-颈内静脉法,VAV插管为股静脉-颈内静脉-升主动脉插管法。并发症主要为出血及肾损伤等,大部分均能顺利撤机。结论ECMO技术是肺移植围术期内安全有效的支持手段,其流转和插管方式、撤除时机、并发症处理等问题需要精细化管理。Objective To summarize the application and management of ECMO in 9 patients with lung transplantation during perioperative period.Methods The data of ECMO assisted lung transplantation patients who have been hospitalized in the thoracic surgery Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University since October 2022 were collected,and their clinical characteristics and management experience were retrospectively analyzed.Results Of the 9 patients,6 received VA-ECMO,2 received VV-ECMO,and 1 received VAV-ECMO.The VA intubation method is the axillary artery femoral vein method,the VV intubation method is the femoral vein internal jugular vein method,and the VAV intubation method is the femoral vein internal jugular vein ascending aorta intubation method.The main complications were hemorrhage and renal injury,and most of them were successfully removed from the machine.Conclusion ECMO technology is a safe and effective support tool during the perioperative period of lung transplantation,and its circulation and intubation methods,removal timing,complications management,and other issues need to be carefully managed.

关 键 词：肺移植 体外膜肺氧合技术 腋动脉插管 

分 类 号：R655.3[医药卫生—外科学]