围手术期无抗凝体外膜肺氧合辅助肺移植治疗8例分析

杨冰心; 李敏; 周蓉; 马千里; 杜忠军; 詹庆元

doi:10.3969/j.issn.1674-7445.2018.02.011

围手术期无抗凝体外膜肺氧合辅助肺移植治疗8例分析

doi: 10.3969/j.issn.1674-7445.2018.02.011

266000 青岛大学附属医院重症医学科（杨冰心、杜忠军）；中日友好医院呼吸与危重症医学科（李敏、周蓉、詹庆元），肺移植科（马千里）

详细信息

作者简介:
杨冰心，女，1982年生，硕士，主治医师，研究方向为重症医学，Email: bingxin1230yang@sohu.com

通讯作者:
李敏，男，1982年生，硕士，主治医师，研究方向为呼吸危重症，Email: qlyy_limin@163.com

中图分类号: R617, R563
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- 被引次数: 0
出版历程
- 收稿日期: 2017-11-04
- 网络出版日期: 2021-01-19
- 刊出日期: 2018-03-15

摘要

摘要: 目的探讨无抗凝体外膜肺氧合（ECMO）在肺移植围手术期中应用的可行性。方法回顾性分析2017年5月至7月在中日友好医院接受围手术期无抗凝ECMO辅助治疗的8例肺移植患者临床资料。其中男6例，女2例，年龄（52±12）岁。所使用的ECMO套包管路为肝素涂层管路，监测患者肺移植术后应用无抗凝ECMO时间，记录患者停用无抗凝ECMO后吸入氧浓度（FiO₂）、24 h及48 h动脉血氧分压（PaO₂）/FiO₂，观察患者术后并发症发生情况。结果 8例患者应用无抗凝ECMO的时间中位数为48（34~53）h，停用无抗凝ECMO后FiO₂为27%~30%；停用无抗凝ECMO后24 h PaO₂/FiO₂为（314±54）mmHg，48 h PaO₂/FiO₂为（306±24）mmHg（10 mmHg=1.33 kPa）。8例患者围手术期无抗凝ECMO辅助治疗的肺移植患者均成功撤离ECMO，ECMO运转过程及停用无抗凝ECMO后均未发生膜肺血栓及无抗凝ECMO相关血栓性疾病。结论对有出血倾向的患者，肺移植围手术期应用有肝素涂层管路的ECMO套包进行无抗凝ECMO是安全、可行的。
- 肺移植 /
- 体外膜肺氧合（ECMO） /
- 围手术期 /
- 血栓 /
- 并发症 /
- 凝血 /
- 肝素 /
- 血气分析

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参考文献(19)

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