目的 总结经皮心肺辅助循环系统(PCPS)对危重症患者支持治疗的临床经验,并探讨影响患者预后的危险因素.方法 回顾性收集分析2006年9月至2013年2月收住浙江省人民医院重症监护病房的22例严重急性心肺功能衰竭患者接受PCPS支持的基本资料和治疗情况,按预后将其分为康复出院组与院内死亡组,分析筛选影响预后的危险因素.结果 PCPS辅助循环时间2~334(75±1O)h,成功脱机14例(63.6%),出院12例(54.6%),出院组与死亡组的PCPS前血乳酸水平为(4.6±2.0)与(9.5±6.1) mmol/L,心脏射血分数为0.35±0.03与0.26 ±0.01,序贯器官衰竭评估(SOFA)评分为8.4±1.9与11.1±2.3,多脏器衰竭(>3个)两组间比较差异均有统计学意义(均P<0.05).结论 PCPS是治疗急性严重心肺衰竭的有效手段,PCPS前血乳酸水平、心脏射血分数、SOFA评分、多脏器衰竭(>3)可能是影响预后的相关危险因素.
Objective To summarize the experiences of percutaneous cardiopulmonary support system (PCPS) for critically ill patients and examine the risk factors associated with prognosis.Methods The clinical data of 22 patients with acute severe cardiorespiratory failure on PCPS at intensive care unit of Zhejiang Provincial People's Hospital from September 2006 to February 2013 were retrospectively collected and analyzed.According to the prognosis,they were divided into the survival and mortality groups.And their risk factors of prognosis were analyzed.Results The PCPS support time was 2-334 (75 _± 10)hours,14 cases (63.6%) were successfully weaned and 12 cases (54.6%) discharged.The inter-group differences of blood lactic acid level before PCPS,heart ejection fraction,sequential organ failure assessment (SOFA) score and number of multiple organ failure (〉 3) were statistically significant (P 〈 0.05).Conclusions PCPS is an effective approach for severe acute patients with cardiopulmonary failure.And blood lactic acid level before PCPS,heart ejection fraction,SOFA score and number of multiple organ failure (〉 3) may be the risk factors related with prognosis.