体外膜肺氧合期间超滤技术的应用

摘要

OBJECTIVE To introduce the connection and effect of extracorporeal memhrane oxygenation ( ECMO ) combination with ultrafiltration in extracorporeal circulation. METHODS 3 severe heart disease patients with anuria and tissue oedema,whose age ranged from 57 years to 78 years ( average 69 years ) and body weight ranged from 63 kg to 89 kg ( average 73. 6 kg ) were treated with Medtronic ECMO circuit to assist cardiac function. The ultrafiltration devise with idio - designed methods was connected at the three - way joint of ECMO circuit and negative pressure site of centrifugal pump. RESULTS The ultrafiltration volume during ECMO assisting ranged from 5 750 ml to 14 850 ml of the three patients. After ECMO assisting combination with ultrafiltration for 36 hours and 42 hours. urinary production of two patients were recovery, who weaned off ECMO after cardiac function recovery and discharged. Another patient gave up treatment after ECMO assisting for 48 hours and left hospital. CONCLUSION For ECMO combination with ultrafiltration in extracorporeal circulation, the conjunction was simple , deflation was thorough and convenient, the effect of filtration was well and safe. Ultrafiltration was fitted for ECMO assist homeochronously.%目的 总结体外膜肺氧合(ECMO)中结合超滤一体化连接方法及应用效果.方法 3例重症心脏病患者,年龄57～78(69)岁,体重63～89(73.6)kg.采用Medtronic ECMO管路行ECMO心功能支持,ECMO前及ECMO期间无尿、组织脏器水肿,在ECMO管路三通板处与离心泵接负压处连接超滤.结果 3例患者在ECMO过程中滤水5 750～14 850 ml,2例患者经过ECMO辅助联合超滤治疗后36 h、42 h尿量逐渐恢复,心功能恢复后撤除ECMO,后康复出院,另1例患者ECMO辅助48 h,家属放弃治疗自动出院.结论 ECMO中结合超滤连接方法简便,排气方便彻底,滤水效果良好、安全,适合ECMO过程中同期使用.