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目的:考察体外膜肺氧合在急性大面积肺血栓栓塞症救治中的临床应用效果。方法:将60例急性大面积肺血栓栓塞症患者随机分为研究组和对照组,每组各30例。对照组患者给予外科取栓治疗,研究组患者在此基础上加用体外膜肺氧合治疗。比较2组患者病死率、治疗前后血流动力学指标、血气指标和右心功能指标。结果:研究组患者病死率显著低于对照组(P<0.05)。2组患者治疗后血流动力学指标均显著改善(P<0.05),但2组血流动力学指标比较,差异无统计学意义。研究组患者治疗后各时点PaCO2水平显著低于对照组(P<0.01),其他血气指标显著高于对照组(P<0.01)。研究组患者治疗后右心功能各指标均显著优于对照组(P<0.01)。结论:体外膜肺氧合治疗应用于急性大面积肺血栓栓塞症救治可以有效改善患者血气指标,进而提高生存率,改善患者预后。
Objective: To investigate the clinical application of extracorporeal membrane oxygenation in the treatment of acute large area pulmonary thromboembolism. Methods: Sixty patients with acute large area pulmonary thromboembolism were randomly divided into study group and control group, with 30 cases in each group. Patients in the control group were given surgical thrombectomy. Patients in the study group were treated with extracorporeal membrane oxygenation. The mortality of patients in two groups were compared, before and after treatment, hemodynamics, blood gas and right heart function. Results: The mortality of study group was significantly lower than that of control group (P <0.05). The hemodynamic parameters of two groups were significantly improved after treatment (P <0.05), but there was no significant difference between the two groups in the hemodynamic parameters. The PaCO2 level of study group was significantly lower than that of control group (P <0.01), and the other indexes of blood gas were significantly higher than those of control group (P <0.01). The indexes of right heart function in study group were significantly better than those in control group (P <0.01). Conclusion: The use of extracorporeal membrane oxygenation therapy in the treatment of acute large area pulmonary thromboembolism can effectively improve the blood gas indexes, improve the survival rate and improve the prognosis of patients.