体外膜肺氧合(ECMO)与多学科协作在急性暴发性心肌炎患者中的应用
Application of Extracorporeal Membrane Oxygenation (ECMO) and Multidisciplinary Cooperation in Patients with Acute Fulminant Myocarditis

目的：探讨体外膜肺氧合(ECMO)与多学科协作在急性暴发性心肌炎患者救治过程中的护理要点。方法：回顾性分析我科2020年6月收治一例急性重症心肌炎合并心源性休克、肾功能衰竭患者，经ECMO (体外膜肺氧合)、呼吸机辅助呼吸、主动脉内球囊反搏泵(IABP)、连续肾脏替代疗法(CRRT)联合抢救治疗护理及临床转归。结论：体外膜肺氧合(ECMO)作为一种重要的体外生命支持技术，临床上主要用于心脏功能不全和(或)呼吸功能不全的支持，目前已经成为治疗难以控制的严重心力衰竭和呼吸衰竭的关键技术，患者心脏骤停经传统心肺复苏15 min后仍不能维持自主循环者为暴发性心肌炎ECMO治疗的适应症，ECMO使用期间，涉及医院多个部门及多个专科的多学科团队共同协作，实施精细化护理，有利于加快患者心功能恢复，挽救患者的生命，获得较好的临床转归。
Objective: To explore the nursing points of extracorporeal membrane oxygenation (ECMO) and multidisciplinary cooperation in the treatment of patients with acute fulminant myocarditis. Methods: A retrospective analysis of a patient with acute severe myocarditis combined with cardiogenic shock and renal failure in our department in June 2020 was retrospectively analyzed. The patient received ECMO (extracorporeal membrane oxygenation), ventilator assisted breathing, and intra-aortic balloon pump (IABP), continuous renal replacement therapy (CRRT) combined rescue treatment, nursing and clinical outcome. Conclusion: Extracorporeal membrane oxygenation (ECMO), as an important extracorporeal life support technology, is mainly used clinically to support cardiac insufficiency and/or respiratory insufficiency. It has become a treatment for severe heart failure and respiratory failure that are difficult to control. The key technology for patients who suffer from cardiac arrest and cannot maintain spontaneous circulation after 15 minutes of traditional cardiopulmonary resuscitation is the indication for ECMO treatment of fulminant myocarditis. During ECMO use, it involves the collaboration of multidisciplinary teams from multiple hospitals and multiple specialties. The implementation of refined care is conducive to speeding up the recovery of patients’ heart function, saving patients’ lives, and obtaining better clinical outcomes.