体外膜肺氧合插管相关感染的研究进展
Research progress on the extracorporeal membrane oxygenation intubation-related infection
李昆雨 1高国栋1
作者信息
- 1. 中国医学科学院北京协和医学院国家心血管病中心阜外医院体外循环中心,北京 100037
- 折叠
摘要
体外膜肺氧合(ECMO)常用于心肺功能严重衰竭患者的过渡治疗,通过静脉插管引出未氧合的血液,经过氧合后再将血液输回动脉或静脉系统.动静脉插管存在插管相关感染的发生风险,感染一旦发生,会延长患者的住院时间,增加患者的病死率和医疗费用.较长的ECMO持续时间、较高的简化急性生理学评分(SAPS)等均是感染的危险因素.目前针对感染的主要诊断方法是血培养.超声引导下经皮穿刺置管可降低感染风险,若仍发生感染则需积极进行抗菌药物治疗.本文围绕ECMO插管相关感染,对其发生率、危险因素、诊断标准、预防策略、治疗方法等要点进行综述,以期为临床工作带来借鉴意义.
Abstract
Extracorporeal membrane oxygenation(ECMO)is commonly a transitional treatment way used in patients with severe heart and lung problem.Deoxidized blood is extracted through venous intubation,and then returned to the arterial or venous system after oxygenation.There is a risk of intubation-related infection in arterial or venous intubation.Once the infection occurs,it will prolong the patient's length of hospitalization stay,increase the mortality and medical expenses.Longer duration of ECMO and higher simplified acute physiology score(SAPS)were risk factors for infection.At present,the main diagnostic method for infection is blood culture.Ultrasound-guided percutaneous cannulation can reduce the occurrence of infection;if infection still occurs,antibiotics should be actively treated.In order to bring reference for clinical work,this article reviews the incidence,risk factors,diagnostic criteria,prevention strategies,treatment methods and other key points of ECMO intubation-related infection.
关键词
体外膜肺氧合/医院感染/危险因素/插管Key words
Extracorporeal membrane oxygenation/Nosocomial infection/Risk factor/Intubation引用本文复制引用
基金项目
中国医科院临床与转化医学研究项目(2021-I2M-C&T-B-034)
出版年
2024
NETL
NSTL
万方数据