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国际医学与数据杂志

International Journal of Medicine and Data

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International Journal of Medicine and Data. 2024; 8: (1) ; 10.12208/j.ijmd.20240005 .

Research on the application of ECMO in severe pneumonia
ECMO在重症肺炎中的应用研究

作者: 霍小艳 *

榆林市第二医院重症医学科 陕西榆林

*通讯作者: 霍小艳,单位:榆林市第二医院重症医学科 陕西榆林;

引用本文: 霍小艳 ECMO在重症肺炎中的应用研究[J]. 国际医学与数据杂志, 2024; 8: (1) : 15-18.
Published: 2024/2/27 9:24:31

摘要

目的 研究重症肺炎治疗中应用ECMO(体外膜肺氧合)的有效价值。方法 将2022年10月-2023年12月时间内受诊的重症肺炎患者88例列入观察范围,以数字表法的形式进行两组划分,即基础机械通气干预的基础干预组、体外膜肺氧合干预的氧合干预组,对比两组身体指标变化情况、治疗效果。结果 氧合干预组16例患者属于病情明显好转结果、25例患者属于病情一般好转结果、3例患者属于病情无好转结果,病情好转率是93.2%,较基础干预组86.4%高,p<0.05;治疗后,氧合干预组氧合指数项目均值(11.25±3.40)%、血氧分压项目均值(54.78±5.18)mmHg、二氧化碳分压项目均值(51.45±3.55)mmHg、气道阻力项目均值(40.55±4.67)cmH2O/(L·s),均较基础干预组优,p<0.05;氧合干预组不良反应出现率是4.6%,较基础干预组11.4%低(2例感染现象、2例胃肠道不舒适现象、1例异常疼痛现象),p<0.05。结论 重症肺炎的治疗中,应及时引进ECMO技术,提高病情好转率,促进呼吸指标改善,保障治疗安全性。

关键词: 体外膜肺氧合;重症肺炎;呼吸指标;不良反应

Abstract

Objective To study the effective value of ECMO (extracorporeal membrane oxygenation) in the treatment of severe pneumonia.
Methods 88 severe pneumonia patients diagnosed between October 2022 and December 2023 were included in the observation range. Two groups were divided using a digital table method, namely the basic intervention group of basic mechanical ventilation intervention and the oxygenation intervention group of extracorporeal membrane oxygenation intervention. The changes in physical indicators and treatment effects of the two groups were compared.
Results In the oxygenation intervention group, 16 patients had a significant improvement in their condition, 25 patients had a general improvement in their condition, and 3 patients had no improvement in their condition. The improvement rate was 93.2%, which was higher than 86.4% in the basic intervention group (p<0.05); After treatment, the mean oxygenation index (11.25 ± 3.40)%, mean blood oxygen partial pressure (54.78 ± 5.18) mmHg, mean carbon dioxide partial pressure (51.45 ± 3.55) mmHg, and mean airway resistance (40.55 ± 4.67) cmH2O/(L · s) in the oxygenation intervention group were all better than those in the basic intervention group, p<0.05; The incidence of adverse reactions in the oxygenation intervention group was 4.6%, which was lower than 11.4% in the basic intervention group (2 cases of infection, 2 cases of gastrointestinal discomfort, and 1 case of abnormal pain), p<0.05.
Conclusion   In the treatment of severe pneumonia, ECMO technology should be introduced in a timely manner to increase the improvement rate of the condition, promote the improvement of respiratory indicators, and ensure the safety of treatment.

Key words: Extracorporeal membrane oxygenation; Severe pneumonia; Respiratory indicators; Adverse reactions

参考文献 References

[1] 王英,辛晨,张婷婷,任师远,赵玉晓,盖玉彪. 清单管理在体外膜肺氧合辅助经皮冠状动脉介入治疗病人围术期中的应用[J]. 全科护理,2023,21(19):2657-2661.

[2] 杨念龙,张堃池,蔡晓,吕胜,张开龙. 体外膜肺氧合成功救治艾滋病患者合并肺孢子菌感染的体会[J]. 内科急危重症杂志,2022,28(05):427-430.

[3] 万娜,李绪言,张春艳,王淑芹,孙兵,徐新,贾燕瑞. 清醒体外膜肺氧合治疗在免疫抑制合并重症肺炎患者中的护理[J]. 护士进修杂志,2022,37(18):1693-1696.

[4] 徐超,靳莉,张华. 体外膜肺氧合联合丙种球蛋白治疗儿童重症腺病毒肺炎合并呼吸衰竭疗效观察[J]. 新乡医学院学报,2022,39(09):859-864.

[5] 施霞,岑福兰,苏志敏,杨根东,李金秀,冯程,陈烨,张国良,王召钦,刘映霞,温隽珉,高虹. 体外膜肺氧合在新型冠状病毒肺炎危重型合并暴发性心肌炎患者中的应用[J]. 中华实验和临床病毒学杂志,2022,36(04):448-454.

[6] 陈红娇,李君,高辉,殷俊,杨清,曹岚. 行体外膜肺氧合治疗联合俯卧位通气重症肺炎患者的个体化肠内营养支持护理1例[J]. 中国实用护理杂志,2022,38(16):1250-1255.

[7] 郑丽,牟春英,黎巧玲. 1例重症肺炎患者体外膜肺氧合合连续性肾脏替代及机械通气治疗的康复护理[J]. 现代临床护理,2021,20(09):81-85.