CAJ | 학술논문

目的总结并初步分析成人心脏术后在应用体外膜肺氧合(ECMO)期间出现的相关并发症.方法收集2008年1月至2012年1月82例成人心脏术后应用体外膜肺氧合期间的相关并发症资料,主要包括肾功能衰竭、感染、出血、下肢缺血、微栓、溶血、肝功能障碍、淋巴漏等并发症.82例患者中男50例,女32例；年龄(51.3±11.0)岁.结果 44例发生并发症,占53.7％.肾衰的发生率及病死率最高,分别为36.6％及56.7％.感染次之,其发生率及病死率分别为34.1％及40.0％.对ECMO与持续性肾替代治疗(CRRT)的最初应用时间的间隔和死亡比例进行回归分析,P=0.012,两者存在相关性,随时间的延长死亡比例增加.结论肾功能衰竭及感染是成人心脏术后应用ECMO期间的最主要并发症,对预后有明显影响,对高危患者进行早期预防和及时治疗具有重要的临床意义.
목적 총결병초보분석성인심장술후재응용체외막폐양합(ECMO)기간출현적상관병발증.방법 수집2008년1월지2012년1월82례성인심장술후응용체외막폐양합기간적상관병발증자료,주요포괄신공능쇠갈、감염、출혈、하지결혈、미전、용혈、간공능장애、림파루등병발증.82례환자중남50례,녀32례；년령(51.3±11.0)세.결과 44례발생병발증,점53.7％.신쇠적발생솔급병사솔최고,분별위36.6％급56.7％.감염차지,기발생솔급병사솔분별위34.1％급40.0％.대ECMO여지속성신체대치료(CRRT)적최초응용시간적간격화사망비례진행회귀분석,P=0.012,량자존재상관성,수시간적연장사망비례증가.결론 신공능쇠갈급감염시성인심장술후응용ECMO기간적최주요병발증,대예후유명현영향,대고위환자진행조기예방화급시치료구유중요적림상의의.
Objective To analyze statistically complications associated with usage of extracorporeal membrane oxygenation after cardiac surgery in 82 cases.This report reviews our experience in extracorporeal membrane oxygenation support treatment in adult patients with cardiac failure after cardiac surgery.Methods To collect statistical data of 82 adult patients with extracorporeal membrane oxygenation support in one ward of Anzhen Hospital from January 2008 to January 2012,including renal failure,infection,haemorrhage,limb ischemia,microembolus,hemolysis,hypohepatia,lymphatic leakage,etc.Results The complication rate was 53.7％ (44 cases).Renal failure morbidity and mortality rates were the highest (36.6％,56.7％).Infection was the second highest(34.1％,40.0％).To analyse the relationship between application timing of continuous renal replacement therapy and mortality of extracorporeal membrane oxygenation by using regression analysis method,P =0.012.Both are related,and mortality increase with time.Conclusion Renal failure and infection are the main complications of adult receiving extracorporeal membrane oxygenation with cardiac surgery,and had significant effect on the prognosis.Application timing of continuous renal replacement therapy and mortality of extracorporeal membrane oxygenation are related.Prevent early and treat timely should be benefit to the patients wih high-risk factors.