体外膜氧合抗凝管理的新进展与挑战  

Recent advances and future perspectives in anticoagulation management for extracorporeal membrane oxygenation

作　　者：徐恩慧 孙琦 卢娟 熊鹰 魏新广 刘燕[1] Xu Enhui;Sun Qi;Lu Juan;Xiong Ying;Wei Xinguang;Liu Yan(Department of Cardiopulmonary Bypass,Wuhan Aisa Heart Hospital Affiliated to Wuhan University of Science and Technology;School of Medicine,Wuhan University of Science and Technology,Hubei Wuhan 430000,China)

机构地区：[1]武汉科技大学附属武汉亚洲心脏病医院体外循环科,武汉430000 [2]武汉科技大学医学部医学院

出　　处：《中国体外循环杂志》2025年第2期176-180,185,共6页Chinese Journal of Extracorporeal Circulation

基　　金：湖北省卫生健康委员会2021指导性项目(WJ2021F018);2023年武汉市医学科学研究项目(WX23A76)。

摘　　要：在体外膜氧合(ECMO)期间,抗凝管理的目标是防止管路、氧合器和患者体内血栓形成,同时最大限度地减少出血并发症。出血及血栓是ECMO治疗中常见的并发症,且与死亡及不良预后的增加显著相关,抗凝治疗是保持ECMO通畅和避免血栓引发并发症的必要条件,同时也是出血性并发症的促成因素。如何减少出血预防血栓形成,成为ECMO支持治疗中面临的首要问题之一。因此,ECMO支持期间凝血情况的监测和抗凝策略变得尤为关键。本文就ECMO运行期间抗凝策略及抗凝监测研究进展进行综述,探讨当前ECMO治疗过程所面临的挑战。During extracorporeal membrane oxygenation(ECMO),the goal of anticoagulation management is to prevent thrombus formation within the circuit,oxygenator,and the patient's body,as well as minimizing bleeding complications.Bleeding and thrombosis are common complications in ECMO therapy and are significantly associated with increased mortality and adverse outcomes.Anticoagulation is essential for maintaining ECMO circuit patency and preventing thromboembolic complications but also contributes to bleeding complications.How to reduce bleeding while preventing thrombus formation has become one of the primary challenges in ECMO support.Therefore,monitoring coagulation status and implementing anticoagulation strategies during ECMO support are particularly critical.This article reviews the latest research progress on anticoagulation strategies and monitoring during ECMO and explores the challenges currently faced in ECMO treatment.

关 键 词：体外膜氧合 抗凝 抗凝管理 监测 进展 

分 类 号：R654.2[医药卫生—外科学]