【摘要】 目的探讨不同时机体外膜肺氧合(ECMO)在急性暴发性心肌炎(FM)患者中的效果比较。方法选择2017年1月至2019年7月我院收治的41例急性FM患者,根据实行ECMO的时机分为甲组20例和乙组21例,甲组实行ECMO时为FM患者合并严重心律失常,且尚未出现心脏骤停;乙组实行ECMO时为FM患者已出现心脏骤停,且行心肺复苏(CPR)无反应或反应不良。两组均实行ECMO救治并实施护理。比较两组患者的治愈率、血流动力学、并发症发生情况。结果两组患者的治愈率比较,差异无统计学意义(P> 0. 05)。ECMO干预24 h后的收缩压(SBP)、舒张压(DBP)、心率(HR)较干预前有明显改善,且甲组SBP,DBP略高于乙组,HR略低于乙组,差异有统计学意义(P <0. 05)。甲组的并发症发生率低于乙组,差异有统计学意义(P <0. 05)。结论 ECMO可有效治疗急性FM,选择合适的治疗时机并实行ECMO护理,可改善血流动力学、降低并发症发生。更多还原

【Abstract】 Objective To explore the effect comparison of extracorporeal membrane oxygenation( ECMO) in patients with acute fulminant myocarditis( FM) at different times. Methods To select 41 cases of patients with cute FM admitted to our hospital from January 2017 to July 2019. According to the timing of ECMO implementation,they were divided into group A with 20 cases and group B with 21 cases. The Group A was an FM patient with severe arrhythmia during ECMO and there was no cardiac arrest. In group B,cardiac arrest occurred in FM patients when ECMO was performed,and cardiopulmonary resuscitation( CPR) was unresponsive or unresponsive. Both groups were treated with ECMO and provided nursing. The cure rate,hemodynamics,and complications of patients of the two groups were compared. Results There was no significant difference in cure rate between the two groups( P > 0. 05).The systolic blood pressure( SBP),diastolic blood pressure( DBP),and heart rate( HR) at 24 h after ECMO intervention were significantly improved,the SBP and DBP of group A were slightly higher than those of group B,the HR was slightly lower than that of group B,and the differences were statistically significant( P < 0. 05). The incidence of complications in the group A was lower than that in the group B,and the difference was statistically significant( P< 0. 05). Conclusion The application of ECMO could effectively treat acute FM. Choosing the right treatment timing and implementing ECMO nursing could improve hemodynamics and reduce complications.更多还原