实用器官移植电子杂志 ›› 2023, Vol. 11 ›› Issue (3): 237-241.DOI: 10.3969/j.issn.2095-5332.2023.03.009

• 论著 • 上一篇    下一篇

肺移植围术期 ECMO 应用经验分析 

王泓懿 1 ,李益行 1 ,高山 1 ,林婷 2 ,高洁 2 ,王绩钊 1 ,赵睿 1 ,郭锋伟 3 ,李硕 1 ,张广健 1   

  1. 1. 西安交通大学第一附属医院胸外科,陕西 西安 710061 ;

    2. 西安交通大学第一附属医院外科 ICU,陕西 西安 710061 ;

    3. 西安交通大学第一附属医院心外科,陕西西安 710061

  • 出版日期:2023-05-20 发布日期:2023-07-06
  • 基金资助:

    10.3969/j.issn.2095-5332.2023.03.009 

Experience analysis of perioperative ECMO application in lung transplantation 

Wang Hongyi 1 ,Li Yixing 1 ,Gao Shan 1 ,Lin ting 2 ,Gao jie 2 ,Wang Jizhao 1 ,Zhao Rui 1 ,Guo fengwei 3 ,Li Shuo 1 ,Zhang Guangjian 1 .   

  1. 1.Department of Thoracic Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China.

    2. Department of Surgical ICU,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China.

    3. Department of Cardiac surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China.

  • Online:2023-05-20 Published:2023-07-06

摘要:

目的 总结 9 例肺移植围术期 ECMO 应用经验和管理要点。方法 收集自 2022 年 10 月以来就诊于西安交通大学第一附属医院胸外科的 ECMO 辅助肺移植患者资料,回顾性分析其临床特点及管理经验。结果 9 例患者中 6 例行 VA-ECMO,2 例行 VV-ECMO,1 例行 VAV-ECMO。VA 插管方式均为腋动脉 - 股静脉法,VV 插管方式为股静脉 - 颈内静脉法,VAV 插管为股静脉 - 颈内静脉 - 升主动脉插管法。并发症主要为出血及肾损伤等,大部分均能顺利撤机。结论 ECMO 技术是肺移植围术期内安全有效的支持手段,其流转和插管方式、撤除时机、并发症处理等问题需要精细化管理。

关键词:

肺移植 , 体外膜肺氧合技术 , 腋动脉插管

Abstract:

Objective To summarize the application and management of ECMO in 9 patients with lungtransplantation during perioperative period. Methods The data of ECMO assisted lungtransplantation patients who have been hospitalized in the thoracic surgery Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University since October 2022 were collected,and theirclinical characteristics and managementexperience were retrospectively analyzed.Results Of the9 patients,6 received VA-ECMO,2receivedVV-ECMO,and1 receivedVAV-ECMO. The VA intubation method is the axillary artery femoral vein method,the VV intubation method is the femoral vein internal jugular vein method,and the VAV intubation method is the femoral vein internal jugular vein ascending aorta intubation method. The main complications were hemorrhage and renal injury,and most of them were successfully removedfrom the machine. Conclusion ECMO technology is a safe and effective support tool during the perioperative period of lung transplantation,and its circulation and intubation methods,removal timing,complications management,and other issues need to be carefully managed. 

Key words:

 , Lung transplantation, Extracorporeal membrane oxygenation technique, Axillary artery cannula ,