中国体外循环杂志
中國體外循環雜誌
중국체외순배잡지
CHINESE JOURNAL OF EXTRACORPOREAL CIRCULATION
2014年
4期
215-218,233
,共5页
江春景%杨峰%郝星%邢智辰%徐博%江瑜%杨晓芳%杜中涛%邢家林%侯晓彤
江春景%楊峰%郝星%邢智辰%徐博%江瑜%楊曉芳%杜中濤%邢傢林%侯曉彤
강춘경%양봉%학성%형지신%서박%강유%양효방%두중도%형가림%후효동
体外膜肺氧合%冠状动脉旁路移植术%难治性心源性休克
體外膜肺氧閤%冠狀動脈徬路移植術%難治性心源性休剋
체외막폐양합%관상동맥방로이식술%난치성심원성휴극
Extracorporeal membrane oxygenation%Coronary artery bypass grafting%Refractory postoperative cardiogenic shock
目的:报道体外膜肺氧合( ECMO)对冠状动脉旁路移植术后心源性休克患者的辅助情况,并分析影响辅助结果的相关危险因素。方法系统性回顾本中心2004年6月至2013年12月,58例冠状动脉旁路移植术后出现难治性心源性低心排或术中难以脱离体外循环行ECMO辅助的患者,分析哪些相关危险因素影响ECMO辅助结果。结果所有ECMO患者中43例男性(76%),15例女性(24%),平均年龄(60.0±9.5)岁,平均辅助时间(105.9±53.2)h。45例成功脱离ECMO(77.6%),其中28例存活出院(48.3%)。 Logistic回归分析发现ECMO前心肺复苏(CPR)是影响ECMO辅助结果的独立危险因素(OR:0.21,95%CI:0.05~0.87, P<0.05)。结论 ECMO前CPR是影响辅助结果的独立危险因素。对于冠状动脉旁路移植术后难治性心源性休克的冠心病患者,ECMO是一种有效的辅助治疗措施,在该群ECMO辅助患者中,男性、年龄较小和体表面积较大的患者生存机率可能更高。
目的:報道體外膜肺氧閤( ECMO)對冠狀動脈徬路移植術後心源性休剋患者的輔助情況,併分析影響輔助結果的相關危險因素。方法繫統性迴顧本中心2004年6月至2013年12月,58例冠狀動脈徬路移植術後齣現難治性心源性低心排或術中難以脫離體外循環行ECMO輔助的患者,分析哪些相關危險因素影響ECMO輔助結果。結果所有ECMO患者中43例男性(76%),15例女性(24%),平均年齡(60.0±9.5)歲,平均輔助時間(105.9±53.2)h。45例成功脫離ECMO(77.6%),其中28例存活齣院(48.3%)。 Logistic迴歸分析髮現ECMO前心肺複囌(CPR)是影響ECMO輔助結果的獨立危險因素(OR:0.21,95%CI:0.05~0.87, P<0.05)。結論 ECMO前CPR是影響輔助結果的獨立危險因素。對于冠狀動脈徬路移植術後難治性心源性休剋的冠心病患者,ECMO是一種有效的輔助治療措施,在該群ECMO輔助患者中,男性、年齡較小和體錶麵積較大的患者生存機率可能更高。
목적:보도체외막폐양합( ECMO)대관상동맥방로이식술후심원성휴극환자적보조정황,병분석영향보조결과적상관위험인소。방법계통성회고본중심2004년6월지2013년12월,58례관상동맥방로이식술후출현난치성심원성저심배혹술중난이탈리체외순배행ECMO보조적환자,분석나사상관위험인소영향ECMO보조결과。결과소유ECMO환자중43례남성(76%),15례녀성(24%),평균년령(60.0±9.5)세,평균보조시간(105.9±53.2)h。45례성공탈리ECMO(77.6%),기중28례존활출원(48.3%)。 Logistic회귀분석발현ECMO전심폐복소(CPR)시영향ECMO보조결과적독립위험인소(OR:0.21,95%CI:0.05~0.87, P<0.05)。결론 ECMO전CPR시영향보조결과적독립위험인소。대우관상동맥방로이식술후난치성심원성휴극적관심병환자,ECMO시일충유효적보조치료조시,재해군ECMO보조환자중,남성、년령교소화체표면적교대적환자생존궤솔가능경고。
Objective To report the outcome of patients with refractory postoperative cardiogenic shock (PCS) after coronary artery bypass grafting ( CABG) treated with extracorporeal membrane oxygenation ( ECMO) in our center, and to analyze the risk fac?tors of clinical outcomes. Methods From 2004 June to 2013 December, the condition of 58 patients treated with ECMO because of PCS after CABG or unsuccessfully weaning from cardiopulmonary bypass ( CPB) during surgery were systematicly reviewed, and the risk factors possibly associated with these patients'outcome were analyzed. Results In all these ECMO assisting patients, there were 43 males (76%) and 15 females (24%), with the mean age of 60 ± 9.5 years and the mean ECMO support duration of 105.9±53.2 h. Among them, 45 cases successfully weaned from ECMO (77.6%) and 28 cases discharged from hospital. Logistic analysis revealed that cardiopulmonary resuscitation ( CPR) before ECMO was an independent risk factor affected clinical outcomes of these patients ( OR:0. 21, 95% CI:0.05~0.87, P<0.05) . Conclusion ECMO is an effective measure for patients occurred PCS after CABG. Male, youn?ger and patients with larger body surface area may be more likely to survive in these ECMO patients. In addition, CPR before ECMO is an independent risk factor affecting ECMO support outcomes.