体外膜肺氧合术后引入DSA血管造影的价值  

he clinical value of introducing DSA angiography after extra corporeal membrane oxygenation

作　　者：丁语[1] 皮梦奇 赵磊[1] 徐伟洋 徐淼 范新东[2] DING Yu;PI Mengqi;ZHAO Lei;XU Weiyang;XU Miao;FAN Xindong(Department of Interventional Hemangioma&Vascular Surgery,Affiliated Children′s Hospital of Zhengzhou University,Zhengzhou,Henan Province 450018,China)

机构地区：[1]郑州大学附属儿童医院介入血管瘤&血管外科,河南郑州450018 [2]上海交通大学医学院附属第九人民医院介入科

出　　处：《介入放射学杂志》2025年第1期33-36,共4页Journal of Interventional Radiology

摘　　要：目的初步探讨数字减影血管造影应用于体外膜肺氧合(extra corporeal membrane oxygenation,ECMO)术后在明确肢体缺血原因方面的精准性和有效性价值。方法回顾性分析郑州大学附属儿童医院2023年7月至10月共3例4次儿童围ECMO期出现的急性肢体缺血情况,经紧急血管造影后迅速明确病因,选择合适的方案处理,开通右下肢血管。结果3例患儿在进入手术室经DSA检查后均快速查明病因,经处理后下肢血供恢复。除1例患儿因肢体反复缺血再灌注损伤,远端肢体出现不可逆性坏死需要截肢,余均恢复良好。结论在儿童ECMO后预防性或肢体有缺血表现时尽早引入DSA检查可迅速明确病因,以恢复肢体血供,增加保肢率。Objective To discuss the accuracy and effectiveness of digital subtraction angiography(DSA) in determining the cause of limb ischemia after extra corporeal membrane oxygenation(ECMO).Methods The clinical data of 3 child patients, who developed 4 times of acute limb ischemia during perioperative period of ECMO at the Affiliated Children′s Hospital of Zhengzhou University of China from July to October of 2023,were retrospectively analyzed.In all the child patients, emergency angiography was carried out to quickly identify the cause, then, appropriate treatment plan was adopted to open the blood vessels of the right lower limb.Results After the child patients entered the operating room and received DSA examination, the causes of the limb ischemia were quickly identified.After treatment, the blood supply to the lower limbs was restored.Except for one child who experienced irreversible necrosis of the distal limb due to repeated ischemia-reperfusion injury and required amputation, the other two child patients recovered well.Conclusion It is of great significance to perform DSA examination as soon as possible when the child patients develop limb ischemic manifestations after ECMO so as to quickly identify the cause, promptly restore blood supply to ischemic limbs and increase limb preservation rate, besides, DSA examination can also be used as a preventive measure for child patients after ECMO.

关 键 词：体外膜肺 急性动脉缺血 血管造影 并发症 

分 类 号：R654.3[医药卫生—外科学]