急诊体外循环在危重心血管患者抢救中的应用.docVIP

精品论文 参考文献 急诊体外循环在危重心血管患者抢救中的应用 泸州医学院附属医院急诊科 四川泸州 646000 摘要：目的 对急诊应用体外循环抢救危重心血管患者的临床效果评价。方法 选取我院2005年3月至2013年2月应用体外循环抢救和治疗危重心血管患者69例，男性患者45例，女性患者24例，平均年龄33.0岁；其中有7例患者在病房或ICU发生心搏骤停，急诊冠状动脉旁路移植术14例，手术室或介入导管室心搏骤停5例，术中出现心脏、大血管损伤8例，5例婴幼儿术前呼吸困难、肺炎、心衰需急诊手术，感染性心内膜炎急诊手术5例，心血管术后左房和左室破裂、右室出血、残留瓣组织影响人工瓣活动等15例，介入治疗出现医源性心脏、大血管损伤4例，介入封堵治疗出现意外6例。对69例患者实施急诊体外循环抢救和治疗，其中浅低温51例，中低温12例，深低温低流量3例，3例左心辅助转流；有3例患者行主动脉和左房插管左心流转，4例股-股体外循环，62例常规插管急诊体外循环。结果 69例危重心血管患者经治疗后成活63例，有效率92%，对63例患者术后进行2~7年随访记录，患者均生存良好。结论 急诊体外循环在抢救危重心血管患者中具有较好的临床效果，加强急诊体外循环技术改良及围术期处理，可使急诊体外循环作为心肺复苏和抢救危重病人的重要措施在急救领域中得到可持续发展。 关键词：体外循环；急诊；应用 [Abstract]：objective to emergency application of extracorporeal circulation in rescuing critically ill patients of cardiovascular clinical effect assessment.Methods select our hospital in March 2005 to February 2013 application of extracorporeal circulation rescue and treatment of critically ill patients，69 cases of cardiovascular，45 patients with male，24 patients with female，mean age，33.0 years；Including 7 cases of patients in the ward or cardiac arrest occurred in the ICU，14 cases of emergency coronary artery bypass transplantation，operating room or involvement in international cardiac arrest in 5 cases，heart and great vessels injury in 8 cases，5 cases of infants and young children preoperative Results 69 cases of critically ill patients survival after treatment of 63 cases of cardiovascular，effective rate was 92%，to 2 ~ 7 years of 63 patients with postoperative follow-up records，were well survival patients.Conclusions emergency extracorporeal circulation in rescuing critically ill patients with cardiovascular has good clinical effect，strengthening emergency extracorporeal circulation technology improvement and perioperative treatment，can make the emergency extracorporeal circulation as cardiopulmonary resuscitation（CPR）and the important measures in the field of emergency rescue of critically ill patients get sustainable development. Keywords：extracorporeal circulati