Application of ECMO in severe ARDS
ECMO在重度ARDS中的应用研究

摘要

目的 研究重度ARDS患者（急性呼吸窘迫综合征）接受ECMO（体外膜肺氧合）治疗的效果。方法 选取2022年10月-2023年12月阶段内在我院进行诊治的重度急性呼吸窘迫综合征92例患者开展医学实践，随机进行两组划分，有普通治疗方式的药物治疗组（乌司他丁、西维来司他钠）、 ECMO治疗的特殊治疗组，统计两组患者血流动力学指标、氧合指数。结果 干预后，特殊治疗组血流动力学多个指标均较药物治疗组优，p<0.05；干预前，两组患者氧合指数之间数据比较p>0.05。特殊治疗组患者干预后一日氧合指数均值（195.26±12.43）mmHg、干预后两日均值（293.65±20.35）mmHg、干预后一个星期均值（380.75±31.46）mmHg，均高于药物治疗组，p<0.05；特殊治疗组有2例皮肤瘙痒症状、2例患者恶心呕吐症状，出现率8.7%，低于药物治疗组10.9%，p<0.05。结论 重度ARDS治疗中引进ECMO技术，取得显著治疗效果，可以推广。

Abstract

Objective To investigate the effect of ECMO (extracorporeal membrane oxygenation) on severe ARDS patients (acute respiratory distress syndrome).
Methods 92 patients with severe acute respiratory distress syndrome treated in our hospital from October 2022 to December 2023 were selected for medical practice, and randomly divided into two groups: drug treatment group (ulinastatin, cilvelestat sodium) with general treatment, and special treatment group treated with ECMO. The hemodynamic index and oxygenation index of the two groups were analyzed.
Results After intervention, the hemodynamic indexes of the special treatment group were better than those of the drug treatment group, p<0.05; Before intervention, the data of oxygenation index between the two groups were compared (p>0.05). The mean oxygenation index of patients in special treatment group was (195.26±12.43) mmHg in one day after intervention, (293.65±20.35) mmHg in two days after intervention, and (380.75±31.46) mmHg in one week after intervention, which were all higher than those in drug treatment group, p<0.05. There were 2 cases of pruritus and 2 cases of nausea and vomiting in the special treatment group (8.7%), which was lower than 10.9% in the drug treatment group (p<0.05).
Conclusion   The introduction of ECMO technology in the treatment of severe ARDS has achieved remarkable therapeutic effect and can be extended.