摘要
目的 探讨体外膜氧合(ECMO)在经皮冠状动脉介入治疗(PCI)循环辅助中的可行性与安全性。方法 回顾性分析2019年4月至2021年4月北部战区总医院心血管内科收治的34例高危冠心病患者的临床资料,其中男29例,女5例,年龄(62.2±14.8)岁,体重(78.8±11.5)kg,均在ECMO辅助下行PCI,记录患者病死率、ECMO辅助时间等围术期指标。结果 26例(76.5%)患者导管室内直接撤除ECMO,8例(23.5%)患者监护室内撤除ECMO,其中4例(11.8%)ECMO辅助8 h内撤除,4例(11.8%)进行长时间辅助并增加远端灌注,术中ECMO流量1.55(1.5,1.7)L/min,围术期死亡3例(8.8%)。股动脉插管均选择15 Fr,股静脉插管以21 Fr为主。结论 ECMO可以安全的用于高危PCI辅助。15 Fr股动脉插管也可以用于绝大部分患者,1.55L/min的ECMO流量可以安全的用于绝大部分患者PCI过程中的辅助。
Objective To evaluate the feasibility and safety of extracorporeal membrane oxygenation(ECMO) in complex high-risk coronary disease for percutaneous coronary intervention(PCI).Methods 34 patients in the Department of Cardiology,General Hospital of Northen Theater Command diagnosed from April 2019 to April 2021 as complex high-risk coronary disease(29 male and 5 female) with an average age of(62.2±14.8) and weight of(78.8 ± 11.5)kg were enrolled in the study,who underwent PCI with ECMO assisted.The perioperative characteristics including mortality and ECMO duration time were recorded.Results 26 patients were weaned from ECMO in the cath lab;4 patients were weaned from ECMO in ICU in 8 h;and 4 patients were weaned from long term support ECMO with distal perfusion.The intraoperative flow of ECMO was 1.55(1.5,1.7)L/min.The perioperative mortality was 8.8%.15 Fr femoral artery cannula was selected in all patients,while 21 Fr femoral vein cannula was selected in most patients.Conclusions ECMO in the patients with complex high risk coronary artery disease undergoing PCI is safe and feasible.
作者
石云
王斌
肖雄
国一白
梁振洋
关绍义
刘宇
SHI Yun;WANG Bin;XIAO Xiong;GUO Yi-bai;LIANG Zhen-yang;GUAN Shao-yi;LIU Yu(Department of Cardiovascular Surgery,General hospital of Northen Theater Command,Shenyang 110016,China;Department of Cardiology,General hospital of Northen Theater Command,Shenyang 110016,China)
出处
《中国心血管病研究》
CAS
2022年第9期817-820,共4页
Chinese Journal of Cardiovascular Research
基金
辽宁省“兴辽英才计划”项目(XLYC2007053)。
关键词
体外膜氧合
冠状动脉介入治疗
高危患者
Extracorporeal membrane oxygenation
Percutaneous coronary intervention
Perfusionist
