体外膜氧合治疗甲型H1N1流感危重症合并呼吸衰竭4例临床疗效观察

›› 2010, Vol. 9 ›› Issue (6): 298-301.

体外膜氧合治疗甲型H1N1流感危重症合并呼吸衰竭4例临床疗效观察

熊号峰郭利民李兴旺焦以庆李宝顺

首都医科大学传染病研究所北京地坛医院危重症内科部感染中心

收稿日期:2010-01-12 修回日期:1900-01-01 出版日期:2010-06-12 发布日期:2010-06-12
通讯作者: 郭利民

Application of extracorporeal membrane oxygenation in critical influenza type H1N1 infection patients with respiratory failure: report of 4 cases

XIONG Hao-feng, GUO Li-min, LI Xing-wang, JIAO Yi-qing, LI Bao-shun

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Received:2010-01-12 Revised:1900-01-01 Online:2010-06-12 Published:2010-06-12

摘要/Abstract

摘要：

【摘要】目的探讨体外膜氧合(extracorporeal membrane oxygenation，ECMO)治疗在危重症甲型H1N1流感患者救治中的作用。方法自2009年10月3日至12月25日，北京地坛医院共收治危重症甲型H1N1流感患者58例，其中实施ECMO治疗患者4例。结果 4例患者中，3例顺利撤离ECMO装置，脱机率为75%，其中2例康复出院，2例死亡。ECMO治疗后, 氧合指数由48～77 mm Hg[1 mm Hg=0.133 kPa，平均(59.8±12.4)mm Hg]升高至122～254 mm Hg[平均(191.8±85.1)mm Hg]。主要并发症有出血和渗血3例，导管感染2例，膜肺血栓2例。结论对于危重症甲型H1N1流感合并急性呼吸窘迫综合征的患者，在经高呼吸机条件仍不能纠正缺氧状况的情况下，ECMO可作为一种有效的治疗手段加以应用。

关键词: 甲型H1N1流感, 危重症, 呼吸衰竭, 体外膜氧合

Abstract:

【Abstract】 Objective To evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) in the treatment of critical influenza type H1N1 infection patients. Methods We treated 4 critical influenza type H1N1 infection patients with ECMO during the period of Oct. 3 to Dec. 25, 2009. Results After the ECMO treatment, 3 of the 4 patients evacuated from ECMO devices successfully. Two patients died, and two patients discharged from hospital. During the treatment, the oxygenation index increased from 48~77mmHg (mean 59.8mmHg) to 122~254mmHg (mean 191.8mmHg). The complications included hemorrhage, catheter related infection, and thrombosis in oxygenation membrane. Conclusion ECMO support may be helpful for some influenza infection patients with severe pulmonary failure refractory to conventional management.

Key words: Critical care, Respiratory failure, Extracorporeal membrane oxygenation

熊号峰郭利民李兴旺焦以庆李宝顺. 体外膜氧合治疗甲型H1N1流感危重症合并呼吸衰竭4例临床疗效观察[J]. , 2010, 9(6): 298-301.

XIONG Hao-feng;GUO Li-min;LI Xing-wang;JIAO Yi-qing;LI Bao-shun. Application of extracorporeal membrane oxygenation in critical influenza type H1N1 infection patients with respiratory failure: report of 4 cases[J]. , 2010, 9(6): 298-301.