CAJ | 학술논문

目的：探讨体外膜肺氧合（ ECMO）在捐献供体器官移植中应用的伦理学意义。方法分析ECMO在13例公民脑死亡后捐献供体器官保护的各项指标数据，核算因ECMO造成的医疗成本升高情况并深入受者家属进行沟通访谈。结果13例脑死亡（ DBD ）供者行ECMO转流期间，血流动力学逐步稳定，血管活性药物应用明显减少，甚至停用，受损的器官功能明显恢复，共产出经病理活检证实可用于移植的器官38个，其中肾脏26个、肝脏12个。38例受者肾移植手术均顺利完成。医疗费用总体上升5．3％。供者家属和受者及其家属均能接受ECMO的介入。结论 ECMO的应用能有效保护器官，提高器官利用率。相关技术标准的提高，法律、法规的完善及医护人员伦理道德的提高将会推动ECMO在器官移植应用中的发展。
목적：탐토체외막폐양합（ ECMO）재연헌공체기관이식중응용적윤리학의의。방법분석ECMO재13례공민뇌사망후연헌공체기관보호적각항지표수거，핵산인ECMO조성적의료성본승고정황병심입수자가속진행구통방담。결과13례뇌사망（ DBD ）공자행ECMO전류기간，혈류동역학축보은정，혈관활성약물응용명현감소，심지정용，수손적기관공능명현회복，공산출경병리활검증실가용우이식적기관38개，기중신장26개、간장12개。38례수자신이식수술균순리완성。의료비용총체상승5．3％。공자가속화수자급기가속균능접수ECMO적개입。결론 ECMO적응용능유효보호기관，제고기관이용솔。상관기술표준적제고，법률、법규적완선급의호인원윤리도덕적제고장회추동ECMO재기관이식응용중적발전。
Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .