标题：体外膜肺氧合技术在新生儿先天性心脏病术后的临床应用

      作者：郭亚鹏，高宏，曾新艳，张圣惠，赵堃，罗越魁，赵国龙，杨婷婷，孙舜楠，艾武，郭戈    西安交通大学医学部附属西北妇女儿童医院心脏中心，陕西 西安 710061

      卷次： 2019年30卷21期

      【摘要】 目的 总结体外膜肺氧合(ECMO)技术在新生儿先天性心脏病术后心功能衰竭或心脏骤停中的临床救治经验。方法 回顾性分析 2015年1月至2018年10月在西北妇女儿童医院心脏中心行先天性心脏病手术后实施ECMO辅助治疗的 9例新生儿的临床资料。结果 9例新生儿年龄 2~28 d，体质量 3.10~4.20 kg，ECMO辅助时间46~206 h；成功撤机5例，其中存活出院4例，死亡5例；死亡原因：2例因各种原因家属主动放弃治疗，1例为心肺功能无法恢复而撤机失败，1例因腹腔感染导致脓毒血症，1例撤机后出现肾功能衰竭行CRRT治疗失败；并发症以感染、急性肾功能衰竭及出血最为常见。结论 先天性心脏病术后出现心功能衰竭或心脏骤停的新生儿即刻启动ECMO辅助治疗可提高患儿生存率，同时，辅助期间并发症的转归决定了总体的治疗结局。
      【关键词】 新生儿；先天性心脏病；体外膜肺氧合；心功能衰竭；临床结果
      【中图分类号】 R722 【文献标识码】 A 【文章编号】 1003—6350（2019）21—2792—04

Clinical application of extracorporeal membrane oxygenation after congenital heart surgery in neonates.
GUOYa-peng, GAO Hong, ZENG Xin-yan, ZHANG Sheng-hui, ZHAO Kun, LUO Yue-kui, ZHAO Guo-long, YANG Ting-ting,SUN Shun-nan, AI Wu, GUO Ge. Department of Cardiovascular Surgery, the Northwest Women and Children's HospitalAffiliated to Xi’an JiaoTong University, Xi’an 710061, Shaanxi, CHINA
【Abstract】 Objective To summarize the clinical treatment experience of extracorporeal membrane oxygen-ation (ECMO) in patients with cardiac failure or cardiac arrest after congenital heart surgery. Methods The clinical da-ta of 9 neonates, who underwent ECMO-assisted congenital heart surgery at the Northwest Women and Children’sHospital Affiliated to Xi’an JiaoTong University from January 2015 to October 2018, were retrospectively analyzed.Results The 9 neonates aged from 2 to 28 d, with a birth weights from 3.10 to 4.20 kg and ECMO auxiliary time from46 h to 206 h. Of which, 5 cases were successfully evacuated (4 of which were discharged alive), and 5 cases died. Forthe causes of death: 2 patients voluntarily gave up treatment due to various causes; 1 patient had withdrawal failure dueto failure of cardiopulmonary function recovery; 1 patient had sepsis due to abdominal infection; 1 patient had renal fail-ure due to continuous renal replacement therapy (CRRT) after withdrawal. Complications were most common with infec-tion, acute renal failure and hemorrhage. Conclusion The survival rate of neonates with heart failure or cardiac arrestafter congenital heart surgery can be improved by the initiation of ECMO-assisted treatment immediately. The outcomeof treatment is determined by the complications during the treatment.
      【Key words】 Neonates; Congenital heart disease; Extracorporeal membrane oxygenation (ECMO); Heart failure;Clinical outcome