在气管外科手术中进行外科生命支持:一个单一中心20年的经验
Lin Sun1, Liping Xin2, Yuwei Qiu3
1Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai JiaoTong University School of Medicine, 241 Huaihai(W), Xuhui District, Shanghai, 200032, China.
身体外生命支持 (ECLS) 可以帮助复杂的气管手术. 在高危患者中,静脉外膜氧化 (VV- ECMO) 显示出有效性和可接受的结果.
科学领域:
- 心胸外科
- 呼吸系统医学
- 危急护理医学
背景情况:
- 复杂的气管外科手术具有显著的外科风险.
- 在这些手术中提供体外生命支持 (ECLS) 的血液动力和呼吸支持.
- 在气管外科手术中没有确立的基于证据的ECLS协议.
研究的目的:
- 在关键气管外科手术中评估不同ECLS配置的安全性和益处.
- 在这个患者群体中制定应用ECLS的实用方案.
主要方法:
- 在ECLS进行气管手术的67名患者中进行的单中心回顾性队列研究 (2000 - 2020年).
- 患者被分为心肺绕道 (CPB),修改CPB和体外膜氧化 (ECMO).
- 基线特征,并发症,ECLS细节,不良事件和生存率的比较.
主要成果:
- 静脉ECMO (VV-ECMO) 的解剖并发症显著减少 (7. 1%).
- 静脉ECMO (VA-ECMO) 需要更长时间的机械通风 (66分钟).
- 心肺绕道 (CPB) 组出现了较高的手术出血 (460±73毫升).
结论:
- 术内ECLS很少使用,但在气管/心脏外科手术中是有益的.
- 在高风险的气管外科手术中,编程VV-ECMO显示出高效率,可接受的死亡率和发病率.
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