CAJ | 학술논문

目的探讨体外膜肺氧合(ECMO)辅助下救治急性心肌梗死(AMI)并发心脏骤停患者行经皮冠状动脉介入治疗(PCI)的方法,并结合相关文献评价其临床疗效.方法选取5例患者,AMI并发心脏骤停,常规心肺复苏(CPR)无效,在ECMO支持下复苏成功并行急诊PCI治疗.结果 5例患者行ECMO辅助后全部复苏成功,循环稳定后全部实施ECMO辅助下介入治疗.ECMO辅助时间分别为42～220 h(平均126.6 h),3例患者存活痊愈出院；1例患者出现脑出血,于停机后死亡；1例患者脱机20 d后死于呼吸衰竭.结论 AMI并发心脏骤停死亡率较高,早期ECMO支持下心肺复苏后并辅助PCI治疗,可增加早期心脏复苏的可能性,为急诊血运重建治疗创造条件,从而降低危重AMI患者的死亡率,是一种短期有效的生命支持方法.
목적 탐토체외막폐양합(ECMO)보조하구치급성심기경사(AMI)병발심장취정환자행경피관상동맥개입치료(PCI)적방법,병결합상관문헌평개기림상료효.방법 선취5례환자,AMI병발심장취정,상규심폐복소(CPR)무효,재ECMO지지하복소성공병행급진PCI치료.결과 5례환자행ECMO보조후전부복소성공,순배은정후전부실시ECMO보조하개입치료.ECMO보조시간분별위42～220 h(평균126.6 h),3례환자존활전유출원；1례환자출현뇌출혈,우정궤후사망；1례환자탈궤20 d후사우호흡쇠갈.결론 AMI병발심장취정사망솔교고,조기ECMO지지하심폐복소후병보조PCI치료,가증가조기심장복소적가능성,위급진혈운중건치료창조조건,종이강저위중AMI환자적사망솔,시일충단기유효적생명지지방법.
Objective To summarize extracorporeal membrane oxygenation (ECMO) in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) with cardiac arrest,and to evaluate the clinical efficacy comparing with literature review.Methods 5 patients of AMI with cardiac arrest who proved invalid to conventional cardio-pulmonaryresuscitation (CPR),were successfully resuscitated with ECMO support,and underwent emergency PCI with stable hemodynamic status.Results In support of ECMO,4 patients were successfully resuscitated with stable hemodynamic status,and underwent primary PCI.The duration of ECMO support ranged from 42 to 220 h (average 126.6 h).3 patients discharged with full recovery,one patient didn't wean from ECMO successfully,and one died of respiratory failure.Conclusion Although mortality of AMI with cardiac arrest is high,early ECMO-assisted cardiopulmonary resuscitation and secondary PCI treatment increase the possibility of cardiac recovery,and provide conditions for emergency revascularization treatment.This reduces mortality in critical patients with AMI,and is an effective short term life support method.