体外膜肺氧合在暴发型心肌炎致心脏骤停中的应用

doi:10.3969/j.issn.1002-1949.2017.10.007

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摘要目的：探讨急诊体外膜肺氧合（ECMO）在暴发型心肌炎（FM）致心肺复苏(CPR)中的应用价值。方法：选择2015-06～2016-12南京医科大学第一附属医院FM致心脏骤停实施ECMO患者7例，男3例，女4例，年龄15～58岁，平均（29.3±11.5）岁，均采用静脉－动脉（V-A）模式。CPR时间50～180 min，平均(78±45.8)min。CPR到启动ECMO时间8～15 min，平均（11.6±2.63）min。建立ECMO辅助时间40～65 min，平均（52.1±9.49）min。ECMO辅助时间121～288 h，平均(162.1±71.3)h 。结果： 7例患者均恢复自主心律，均成功撤离ECMO辅助，其中6例存活，1例脱机后因感染及中枢神经系统并发症死亡；ECMO期间5例进行CRRT，动脉插管处渗血1例，肢体缺血坏死1例。结论： ECMO应用于FM的治疗,尤其是及早应用,有着良好的效果,可以推荐为成人FM的一线支持治疗方法，可以避免重要脏器不可逆损伤，对提高治疗效果有积极的帮助。

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	陈旭锋
	梅勇
	吕金如
	胡德亮
	张刚
	张劲松

收稿日期: 2017-06-06

基金资助:江苏省自然科学基金（BK20171490）；江苏省高等学校自然科学基金（17KJB320006）

通讯作者: 张劲松（1962-），男，教授，主任医师，科主任，E-mail：zhangjso@163.com

作者简介: 陈旭锋（1978-），男，博士，副主任医师，E-mail:cxfyx@163.com

引用本文:

陈旭锋，梅勇，吕金如,胡德亮，张刚，张劲松. 体外膜肺氧合在暴发型心肌炎致心脏骤停中的应用[J]. 中国急救医学, 2017, 37(10): 903-906.
Chen Xu-feng, Mei Yong, Lv Jin-ru, Hu De-liang, Zhang Gang, Zhang Jin-song. Application of the extracorporeal membrane oxygenation in cardiac arrest caused by fulminant myocarditis. Chinese Journal of Critical Care Medicine, 2017, 37(10): 903-906.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2017.10.007 或 http://www.cnemergency.org.cn/CN/Y2017/V37/I10/903

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