CAJ | 학술논문

目的：探讨组合式体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)联合连续性血液净化(continuous blood purification,CBP)治疗多器官功能衰竭(multiple organ dysfunction syndrome,MODS)患者的护理方法.方法回顾性分析并总结2011年8月至2013年3月,南京军区南京总医院国家肾脏疾病临床医学研究中心重症监护病房收治的6例MODS 患者的临床资料.结果6例患者中发生高胆红素血症1例(16．7％),溶血2例(33．3％),消化道出血1例(16．7％),插管部位出血3例(50．0％)；存活出院1例(16．7％),放弃治疗4例(66．7％),病死1例(16．7％).结论ECMO 联合 CBP 治疗 MODS 患者,有利于避免重要脏器的不可逆损伤,而容量管理、管道维护、血流动力学监测、出凝血指标观察及并发症的预防处理是患者成功救护的重要环节.
목적：탐토조합식체외막폐양합(extracorporeal membrane oxygenation,ECMO)연합련속성혈액정화(continuous blood purification,CBP)치료다기관공능쇠갈(multiple organ dysfunction syndrome,MODS)환자적호리방법.방법회고성분석병총결2011년8월지2013년3월,남경군구남경총의원국가신장질병림상의학연구중심중증감호병방수치적6례MODS 환자적림상자료.결과6례환자중발생고담홍소혈증1례(16．7％),용혈2례(33．3％),소화도출혈1례(16．7％),삽관부위출혈3례(50．0％)；존활출원1례(16．7％),방기치료4례(66．7％),병사1례(16．7％).결론ECMO 연합 CBP 치료 MODS 환자,유리우피면중요장기적불가역손상,이용량관리、관도유호、혈류동역학감측、출응혈지표관찰급병발증적예방처리시환자성공구호적중요배절.
Objective To discuss the nursing method of extracorporeal membrane oxygenation (ECMO) combined continuous blood purification (CBP)in the treatment of patients with multiple organ dysfunction syndrome (MODS).Methods Clinical data of 6 cases of MODS patients in our department from August 201 1 to March 2013 were analyzed retrospectively.Results There is one patient had hyperbilirubinemia (1 6??7%),two cases of hemolysis (33.3%),one case of gastrointestinal hemorrhage (1 6.7%),3 cases of cannulation site bleeding (50.0%);one cases discharged (1 6.7%),giving up 4 patients (66.7%)and 1 pa-tient died (1 6.7%).Conclusion ECMO therapy combined CBP in the treatment of MODS patients can a-void irreversible damage to vital organs,and capacity management,pipeline maintenance,hemodynamic mo-nitoring,the prevention and treatment of complications of coagulation parameters observed in patients are an important part of a successful rescue.