中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
3期
248-254
,共7页
朱建军%刘励军%Philippe Sauder
硃建軍%劉勵軍%Philippe Sauder
주건군%류려군%Philippe Sauder
重症急性呼吸窘迫综合征%体外膜肺%预后
重癥急性呼吸窘迫綜閤徵%體外膜肺%預後
중증급성호흡군박종합정%체외막폐%예후
Severe acute respiratory distress syndrome%Extracorporeal membrane oxygenation%Outcome
目的 分析接受体外膜肺(ECMO)治疗重症急性呼吸窘迫综合征(ARDS)患者的临床特征,探讨影响ECMO治疗重症ARDS预后的因素.方法 回顾性分析法国斯特拉斯堡医学院附属新民众医院2008年11月至2010年9月因常规治疗无效而行ECMO辅助的重症急性呼吸窘迫综合征患者的临床资料,将接受动脉-静脉ECMO治疗患者和ECMO治疗前接受机械辅助通气超过10 d的患者排除在外,根据ECMO治疗后28 d的存活情况,分为存活组和死亡组,比较分析两组患者在转入ICU以及接受ECMO治疗前后的临床特征,通过组间单因素分析筛选出影响ECMO治疗重症ARDS效果的主要因素.结果 共有25例患者进入本研究,其中存活组15例,死亡组10例.研究结果表明,存活组患者年龄明显低于死亡组(49.8±10.5)岁vs.(59.9±11.5)岁,P =0.044,并且存活组患者感染甲型H1N1比例明显高于死亡组(x2=3.896,P=0.048).另外,接受ECMO治疗前,存活组患者机械通气时间明显短于死亡组(57.8±8.7) hvs.(68.3±13.7)h,P=0.013.结论 年龄和接受ECMO治疗前机械通气时间的长短,以及导致重症ARDS的病因是影响ECMO治疗重症ARDS效果的重要因素.
目的 分析接受體外膜肺(ECMO)治療重癥急性呼吸窘迫綜閤徵(ARDS)患者的臨床特徵,探討影響ECMO治療重癥ARDS預後的因素.方法 迴顧性分析法國斯特拉斯堡醫學院附屬新民衆醫院2008年11月至2010年9月因常規治療無效而行ECMO輔助的重癥急性呼吸窘迫綜閤徵患者的臨床資料,將接受動脈-靜脈ECMO治療患者和ECMO治療前接受機械輔助通氣超過10 d的患者排除在外,根據ECMO治療後28 d的存活情況,分為存活組和死亡組,比較分析兩組患者在轉入ICU以及接受ECMO治療前後的臨床特徵,通過組間單因素分析篩選齣影響ECMO治療重癥ARDS效果的主要因素.結果 共有25例患者進入本研究,其中存活組15例,死亡組10例.研究結果錶明,存活組患者年齡明顯低于死亡組(49.8±10.5)歲vs.(59.9±11.5)歲,P =0.044,併且存活組患者感染甲型H1N1比例明顯高于死亡組(x2=3.896,P=0.048).另外,接受ECMO治療前,存活組患者機械通氣時間明顯短于死亡組(57.8±8.7) hvs.(68.3±13.7)h,P=0.013.結論 年齡和接受ECMO治療前機械通氣時間的長短,以及導緻重癥ARDS的病因是影響ECMO治療重癥ARDS效果的重要因素.
목적 분석접수체외막폐(ECMO)치료중증급성호흡군박종합정(ARDS)환자적림상특정,탐토영향ECMO치료중증ARDS예후적인소.방법 회고성분석법국사특랍사보의학원부속신민음의원2008년11월지2010년9월인상규치료무효이행ECMO보조적중증급성호흡군박종합정환자적림상자료,장접수동맥-정맥ECMO치료환자화ECMO치료전접수궤계보조통기초과10 d적환자배제재외,근거ECMO치료후28 d적존활정황,분위존활조화사망조,비교분석량조환자재전입ICU이급접수ECMO치료전후적림상특정,통과조간단인소분석사선출영향ECMO치료중증ARDS효과적주요인소.결과 공유25례환자진입본연구,기중존활조15례,사망조10례.연구결과표명,존활조환자년령명현저우사망조(49.8±10.5)세vs.(59.9±11.5)세,P =0.044,병차존활조환자감염갑형H1N1비례명현고우사망조(x2=3.896,P=0.048).령외,접수ECMO치료전,존활조환자궤계통기시간명현단우사망조(57.8±8.7) hvs.(68.3±13.7)h,P=0.013.결론 년령화접수ECMO치료전궤계통기시간적장단,이급도치중증ARDS적병인시영향ECMO치료중증ARDS효과적중요인소.
Objective To find out the factors affecting the outcome of severe acute respiratory distress syndrome (ARDS) patients treated with extracorporeal membrane oxygenation (ECMO).Methods From November 2008 to September 2010,patients with severe acute respiratory distress syndrome (ARDS) required extracorporeal membrane oxygenation (ECMO) after failure of conventional therapy were retrospectively studied.Patients treated by veno-arterial ECMO,treated by mechanical ventilation for more than l0 days were excluded.All patients were divided into survival group and non-survival group,according to the 28 day survival situation after ECMO treatment.We compared the clinical data of the two groups when transferred to Intensive Care Unit (ICU),before and after ECMO treatment.We used Independent-samples t test and Chi-square tests to find out the factors affecting the results of ECMO treatment in the patients with severe ARDS.Results A total of twenty-five patients were enrolled in the study,of whom 15 patients survived,10 patients died.The results showed that the average age of the survival group is lower than that of non-survival group (49.8 ± 10.5) vs.(59.9 ± 11.5),P =0.044,and the proportion of patients with severe ARDS caused by Influenza A (H1 N1) in the survival group was higher than that of the non-survival group (x2 =4.453,P =0.048).In addition,the duration of mechanical ventilation before ECMO treatment in the survival group was shorter than that in the non-survival group (57.8 ± 8.7) hours vs.(68.3 ±13.7) hours,P =0.013.Conclusions The age,pre-ECMO ventilation duration and the cause of ARDS are the important factors influencing the efficacy of ECMO treatment in the patients with severe ARDS.
