体外膜肺氧合对重症患者的治疗效果评价

发布时间：2018-01-30 12:55

  本文关键词： 体外膜肺氧合 重症医学 ARDS 治疗效果　出处：《现代预防医学》2015年01期 　论文类型：期刊论文

【摘要】：目的评估体外膜肺氧合对重症患者的治疗效果,为今后临床救治重症ARDS患者提供依据。方法选择2008年1月-2013年3月至我院ICU救治的患者中,由于呼吸窘迫综合症机械通气效果不佳进行ECMO支持治疗的重症患者21例作为研究对象。所有患者均采用静脉-静脉(V-V)体外膜肺流转模式,同时采用保护性肺通气策略,监测中心静脉压。评估治疗前后患者血气指标、APACHEⅡ评分、SOFA评分及患者的转归。结果治疗前患者平均Sa O2为0.81±0.03、Pa CO2为47.3±6.9,p H值为7.10±0.14,经ECMO治疗后的三项指标分别为0.98±0.02、33.5±4.6及7.42±0.08,与治疗前相比差异均具有统计学意义(P0.001);治疗前患者APACHEⅡ评分为17.1±7.3,SOFA评分为7.5±2.2,经过ECMO治疗后APACHEⅡ评分为6.8±3.0、SOFA评分为6.0±1.8,治疗前后相比差异具有统计学意义(P0.05)。在21例接受治疗的患者中,2例死亡,其余19例均顺利出院,死亡率为9.52%。结论 ECMO能减轻重症患者心肺负荷,改善患者缺氧症状,促进心肺的恢复,减少有关并发症的发生。
[Abstract]:Objective to evaluate the effect of extracorporeal membrane oxygenation on severe patients. Methods from January 2008 to March 2013, we selected the patients who were treated with ICU in our hospital from January 2008 to March 2013. Twenty-one patients with severe respiratory distress syndrome who were treated with ECMO support because of poor mechanical ventilation were studied. All patients were treated with IV-VV extracorporeal membrane pulmonary flow model. At the same time, the protective lung ventilation strategy was used to monitor the central venous pressure and to evaluate the blood gas index and Apache 鈪，

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