静脉-静脉体外膜肺氧合应用于新型冠状病毒感染合并Stanford A型主动脉夹层并发术后呼吸衰竭一例  

Veno-venous extracorporeal membrane oxygenation for a Stanford type A aortic dissection patient combined with postoperative respiratory failure and COVID-19:A case report

作　　者：邵宏安 姚跃 王波[1] 汪露[1] 胡静[1] 李庆国[1] SHAO Hongan;YAO Yue;WANG Bo;WANG Lu;HU Jing;LI Qingguo(Department of Cardiovascular Surgery,The Second Affiliated Hospital of Nanjing Medical University,Nanjing,210011,P.R.China)

机构地区：[1]南京医科大学第二附属医院心血管外科,南京210011

出　　处：《中国胸心血管外科临床杂志》2023年第7期967-969,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(82170503);江苏省重点研发计划(社会发展)项目(BE2021749);湖北省卫生健康委员会科研项目青年人才项目(WJ2021Q005)。

摘　　要：自COVID-19流行以来,为有急诊手术指征的COVID-19患者采取手术治疗一直存在争议。Stanford A型主动脉夹层(Stanford type A aortic dissection,STAAD)作为严重威胁患者生命健康的疾病,各大指南都建议第一时间对A型夹层患者行外科手术治疗。然而,术中体外循环对肺部造成的打击对于COVID-19后处于恢复期患者可能是致命的。自COVID-19大流行以来,体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)对于COVID-19并发急性呼吸衰竭患者有重要支持作用。ECMO或许可以同样帮助COVID-19后紧急手术的A型夹层患者,在并发术后呼吸衰竭时渡过难关。本文报道1例应用静脉-静脉体外膜肺氧合(V-V ECMO)成功救治COVID-19后突发STAAD,紧急手术后发生呼吸衰竭的病例。During the new coronavirus disease 2019(COVID-19)pandemic,there has been controversy over whether emergency surgical management should be performed or not in the patients with COVID-19.Stanford type A aortic dissection is a very urgent life-threatening disease,and guidelines recommend surgical treatment for patients with type A aortic dissection in the first instance.However,intraoperative extracorporeal circulation can be fatal to patients recovering from COVID-19.During the pandemic,extracorporeal membrane oxygenation(ECMO)has played an important role in supporting COVID-19 patients with acute respiratory failure.This article reports a successful V-V ECMO treatment for a Stanford type A aortic dissection patient,who suffered respiratory failure caused by COVID-19 after emergency surgery.

关 键 词：主动脉夹层 呼吸衰竭 体外膜肺氧合 新型冠状病毒感染 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学] R654.3[医药卫生—临床医学]