体外膜氧合在高危肺栓塞再灌注治疗中的作用研究进展  

Research progress on the role of extracorporeal membrane oxygenation in the reperfusion treatment of high-risk pulmonary embolism

作　　者：杜佳欣 王君君 张曙光[1] DU Jiaxin;WANG Junjun;ZHANG Shuguang(Department of General Intensive Care Unit,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,Henan Province,China)

机构地区：[1]郑州大学第一附属医院综合ICU,河南郑州450003

出　　处：《新乡医学院学报》2023年第11期1097-1100,共4页Journal of Xinxiang Medical University

摘　　要：肺栓塞起病急、进展快,病死率极高,高危肺栓塞患者常出现右心功能不全、循环衰竭,再灌注治疗前1 h内可迅速发展为心脏骤停。体外膜肺氧合(ECMO)因其可通过迅速恢复血流动力学稳定来改善患者的右心功能不全而越来越多地被用于高危肺栓塞的桥接治疗。但ECMO在高危肺栓塞再灌注治疗中植入时机、治疗模式等并无统一标准,基于此,本文就ECMO治疗高危肺栓塞的病理生理学基础和ECMO在高危肺栓塞再灌注治疗中的应用时机、适用人群及治疗模式的选择等方面进行综述。Pulmonary embolism has a rapid onset,rapid progression,and a high fatality rate.Patients with high-risk pulmonary embolism often experience right heart dysfunction and circulatory failure,which can rapidly develop into cardiac arrest within 1 hour before reperfusion treatment.Extracorporeal membrane oxygenation(ECMO)can significantly improve right ventricular dysfunction by rapidly restoring hemodynamic stability,and is increasingly used as a bridge therapy for high-risk pulmonary embolism.However,there is no unified standard for the implantation timing and treatment mode of ECMO in high-risk pulmonary embolism reperfusion treatment.Based on this,this article reviews the pathological and physiological basis of ECMO for the treatment of high-risk pulmonary embolism,as well as the application timing,suitable population,and treatment mode selection of ECMO in the reperfusion treatment of high-risk pulmonary embolism.

关 键 词：肺栓塞 高危肺栓塞 右心功能衰竭 体外膜氧合 再灌注治疗 桥接作用 

分 类 号：R542.22[医药卫生—心血管疾病]