摘要
目的探讨超声心动图在静脉-动脉体外膜肺氧合(venoarterial extracorporeal membrane oxygenation,VA-ECMO)支持治疗中的应用价值。方法收集2018年6月至2020年2月于本院行VA-ECMO支持治疗的25例患者的超声心动图资料及临床相关资料,其中撤机成功组患者16例,撤机失败组患者9例。分别于建立前、撤机前、撤机后12h内行常规经胸超声心动图检查,测量并记录相关数据,进行对比分析,同时记录应用ECMO的并发症。结果撤机成功患者撤机前和撤机后左室射血分数(ejection fraction of left ventricle,LVEF)及主动脉速度时间积分(aortic velocity time integral,VTIAV)较建立前增加,差异有统计学意义(P<0.05);撤机失败患者撤机前和撤机后LVEF及VTIAV较建立前减低,差异有统计学意义(P<0.05);LVEF及VTIAV在撤机成功患者与撤机失败患者两两比较中,两项指标在建立前差异无统计学意义(P>0.05),在撤机前和撤机后差异均有统计学意义(P<0.05)。本研究中超声检测出的并发症主要有心包积液、血栓、血肿和下肢缺血。结论超声心动图在VA-ECMO支持治疗中对患者心功能监测、撤机时机选择、预后判断及发现并发症具有重要的临床应用价值。
Objective To evaluate the value of echocardiographic in the treatment of venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods Case collection and grouping:Collect the Ultrasound data and clinical related data of 25 patients who underwent VA-ECMO support treatment in our hospital from June 2018 to February 2020.Weaning was successful in 16 cases and failed in 9 cases.Patients underwent routine transthoracic echocardiography before VA-ECMO was established within 12 hours before weaning,and after weaning.The related data were routinely measured and recorded,make a comparative analysis.At the same time,The main complications of ECMO application were recorded.Results The levels of LVEF and VTI_(AV)in successful weaning before and after weaning were significantly higher than those before establishment(P<0.05).The levels of LVEF and VTI_(AV)in failed weaning before and after weaning were significantly higher than those before establishment(P<0.05).In the pairwise comparison of LVEF and VTI_(AV)between the successful weaning and the failed weaning,there was no significant difference between the two groups before establishment(P>0.05),but there were significant differences before and after weaning(P<0.05).The main complications detected by ultrasound in this study were pericardial effusion,thrombus,hematoma and lower limb ischemia.Conclusions Echocardiography has important application value in VA-ECMO supportive therapy.It is an important tool for monitoring cardiac function,choosing the time of weaning,judging the prognosis of patients and detect complications.
作者
付志远
吴维
陈帅
Fu ZhiYuan;Wu Wei;Chen Shuai(The First Affiliated Hospital of Hunan Normal University;Yiyang Central Hospital,Yiyang,China)
关键词
静脉-动脉体外膜肺氧合
超声心动图
主动脉速度时间积分
左室射血分数
Venoarterial extracorporeal membrane oxygenation
Echocardiography
aortic velocity time integral
Left ventricular ejection fraction
作者简介
通信作者:陈帅,E-mail:shuaige419@qq.com
