【摘要】 目的研究容量负荷对危重患者应用体外膜肺(ECMO)救治疗效的影响。方法回顾性分析东莞市人民医院2016年5月年至2019年5月应用ECMO救治的患者,根据上机前基础容量情况,将患者分为容量平衡组、负平衡组、正平衡组,收集各组患者上机成功率;成功患者根据上机后72 h内容量情况,分为容量超负荷(FO)组、非FO组;根据超负荷量,将FO分为三个亚组:FO<10%、10%≤FO<20%、FO≥20%;分别收集APACHEⅡ评分、ECMO上机时间、ICU住院时间、14 d死亡率等指标,进行统计分析。结果上机患者共80例,成功69例;上机成功率基础容量平衡、负平衡、正平衡组间差别比较,差异有统计学意义(P<0.05)。FO与非FO组相比,APACHEⅡ评分之间,差异无统计学意义(P>0.05);FO组ECMO上机时间、ICU住院时间短,与非FO组相比,差异有统计学意义(P<0.05)。FO组14 d死亡率高于非FO组(P<0.05)。FO各亚组间14 d死亡率比较,差异无统计学意义(P>0.05)。结论上机前基础容量状况与上机成功率无关;容量超负荷对危重患者应用ECMO救治时有不良影响。更多还原

【Abstract】 Objective To study the effect of fluid load in critically ill patients treated with extracorporeal membrane oxygenation(ECMO).Methods Retrospective analysis of patients treated with ECMO at the Dongguan City People′s Hospital from May 2016 to May 2019.The patients were divided into the balance group,the negative group and the positive group according to the basic fluid load.It was collected the success rate of each group of the ECMO treatment being into operation and make statistical analysis.The successful cases were divided into the fluid overload(FO)group and the non-overload group according to the fluid capacity within 72 hours after the ECMO running.According to the overload volume,the FO group was divided into three subgroups according to FO< 10%,10%≤FO<20% and FO≥20%.The indicators such as APACHE Ⅱ score,ECMO running time,ICU hospitalization time,and 14-day mortality rate were collected for statistical analysis.Results A total of 80 patients were enrolled and 69 cases were successfully in gear.The difference of the success rate among the basic fluid balance group,the negative group and the positive group there were no statistical significantly differences(P>0.05).The APACHE Ⅱ score showed no statistical difference between the FO and non-overload group.Compared with the non-overload group,the ECMO running time and ICU hospitalization time in the FO group were shorter,and there were statistically significant differences(P<0.05).The 14 day mortality rate of the FO group was higher than that of the non-overload group with statistical significantly differences(P<0.05).There were no statistical significantly differences between the FO subgroups in 14 day mortality(P>0.05).Conclusions The condition of the base fluid load has nothing to do with the success rate of the ECMO being into operation,and fluid overload has a negative effect on the prognosis of patients treated with ECMO.更多还原