| 郭娟,易仁凤,周青.心源性休克患者静脉-动脉体外膜肺氧合脱机结局影响因素[J].中国医学影像技术,2020,36(10):1475~1479 |
| 心源性休克患者静脉-动脉体外膜肺氧合脱机结局影响因素 |
| Impact factors of the outcome of venous-arterial extracorporeal membrane oxygenation weaning in patients with cardiogenic shock |
| 投稿时间：2020-01-07 修订日期：2020-10-02 |
| DOI：10.13929/j.issn.1003-3289.2020.10.008 |
| 中文关键词: 休克,心源性 超声心动描记术 血流动力学 静脉-动脉体外膜肺氧合 |
| 英文关键词:shock, cardiogenic echocardiography hemodynamics venous-arterial extracorporeal membrane oxygenation |
| 基金项目: |
|
| 摘要点击次数: 2446 |
| 全文下载次数: 833 |
| 中文摘要: |
| 目的 探讨心源性休克患者静脉-动脉体外膜肺氧合（V-A ECMO）脱机结局的影响因素。方法 回顾性观察37例接受V-A ECMO辅助心源性休克患者，根据是否耐受脱机试验分为可耐受组及不耐受组；再据最终是否成功脱机将可耐受组患者分为成功脱机亚组（脱机且30天内存活）及脱机失败亚组，比较2亚组患者相关资料，以及脱机试验过程中最低流量水平下2亚组超声测得血流动力学参数。结果 37例中，32例可耐受脱机试验（可耐受组），5例无法耐受（不耐受组）。可耐受组患者年龄（P=0.04）及ECMO辅助中出血率（P<0.01）均低于不耐受组，2组患者性别、原发疾病等差异均无统计学意义（P均>0.05）。可耐受组32例中，22例成功脱机，7例脱机失败，3例死亡。脱机试验中最低流量水平下，脱机成功亚组静脉血氧饱和度（SvO2）、左心室流出道速度-时间积分（LVOT-VTI）、左心室射血分数（LVEF）及二尖瓣环侧壁收缩期运动速度（Sa）均高于脱机失败亚组（P均<0.05）。结论 SvO2、LVOT-VTI、LVEF及Sa均为V-A ECMO辅助心源性休克患者脱机结局的影响因素。 |
| 英文摘要: |
| Objective To explore the impact factors of the outcome of venous-arterial extracorporeal membrane oxygenation (V-A ECMO) in patients with cardiogenic shock. Methods Totally 37 cardiogenic shock patients who received V-A ECMO support were retrospectively analyzed. The patients were divided into tolerance group and intolerance group according to results of tolerance tests, and those in tolerance group were then divided into successful weaning subgroup (weaning and survival within 30 days) and failed weaning subgroup. The baseline data of patients in tolerance group and intolerance group were compared. The hemodynamic parameters measured with echocardiography were compared between successful weaning subgroup and failed weaning subgroup at the lowest flow during the weaning trial. Results There were 32 patients in tolerance group and 5 in intolerance group. Among tolerance group, there were 22 cases in successful weaning subgroup and 7 in failed weaning subgroup,while 3 patients died within 30 days. Age (P=0.04) and bleeding rate (P<0.01) in tolerance group were lower than those in intolerance group, while no statistical difference of gender, primary disease, etc. between the two groups (all P>0.05). During the weaning trial, venous oxygen saturation (SvO2), left ventricular outflow tract velocity-time integral (LVOT-VTI), left ventricular ejection fraction (LVEF) and mitral annulus lateral wall systolic velocity (Sa) of successful weaning subgroup were all higher than those of failed weaning subgroup (all P<0.05). Conclusion SvO2, LVOT-VTI, LVEF and Sa were the impcat factors of outcome of V-A ECMO in patients with cardiogenic shock. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
