段大为,刘迎午,胡晓旻,刘博江,吴鹏,张强,李彤

• 1:天津市第三中心医院心脏中心

摘要(Abstract)：

目的总结体外膜肺氧合(extra-corporeal membrane oxygenation,ECMO)在高危重症冠心病患者心脏不停跳冠状动脉旁路移植术(coronary artery bypass grafting,CABG)中的应用方法和效果。方法选取2007年11月至2014年6月天津市第三中心医院心脏外科的高危重症冠心病行CABG术患者21例,年龄70~83(75.7±3.6)岁,在ECMO辅助下实施择期心脏不停跳CABG术。结果 21例患者中,8例术后即刻顺利脱离ECMO辅助;8例桥血管吻合后ECMO不能立即撤离,继续辅助2.0~4.5 h后撤离;5例在手术室时ECMO不能撤离,关胸后返回冠心病重症监护病房(CCU),考虑ECMO辅助时间较长,为克服ECMO非搏动性灌注,联合主动脉内球囊反搏(intra-aortic balloon pump,IABP)支持,IABP辅助时间76~147(115.2±25.9)h。5例CCU内ECMO辅助患者中:股动静脉插管部位渗血1例,经止血及加压包扎后好转;下肢缺血1例,安装旁路循环后缺血改善;均顺利脱机。21例患者均康复出院,住院时间11~28(17.4±2.8)d。结论 ECMO用于心脏不停跳CABG术可为高危重症冠心病患者提供手术治疗的支持和保护。

关键词(KeyWords)： 体外膜肺氧合;冠心病;冠状动脉旁路移植术;主动脉内球囊反搏

Abstract:

Keywords:

基金项目(Foundation): 天津市自然科学基金(08JCYBJC27200)

作者(Author): 段大为,刘迎午,胡晓旻,刘博江,吴鹏,张强,李彤

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