Venous venous extracorporeal membrane pulmonary oxygenation for the treatment of severe pneumonia caused by yersinia pneumocystis: a case report
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摘要: 重症肺炎具有发病急骤、病死率高的特点，当气管插管、机械通气等传统技术难以改善重症肺炎患者的氧合时，静脉-静脉体外膜肺氧合可作为高级生命支持技术为患者提供氧合支持。本文报道1例通过静脉-静脉体外膜肺氧合技术救治耶氏肺孢子菌引起的重症肺炎患者的临床资料，供同行参考。Abstract: Severe pneumonia has the characteristics of sudden onset and high mortality rate. When traditional techniques such as tracheal intubation and mechanical ventilation are difficult to improve oxygenation in patients with severe pneumonia, venous venous extracorporeal membrane pulmonary oxygenation can serve as an advanced life support technology to provide oxygenation support for patients. This article reports the clinical data of a patient with severe pneumonia caused by Pneumocystis pneumoniae treated by intravenous extracorporeal membrane oxygenation technology, for reference by peers.
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表 1 VV-ECMO治疗前后患者各指标的变化
检测指标 参考值 ECMO启动时 ECMO治疗后 第1天 第2天 第3天 第4天 第5天 WBC/(×109/L) 3.50~9.50 9.85 8.62 8.09 7.50 7.49 5.68 CRP/(mg/L) 0~6 78.08 120.0 127.5 136.4 154.1 78.00 AST/(U/L) 10~40 21 10 11 12 22 13 ALT/(U/L) 10~40 27 16 15 12 28 20 Scr/(μmol/L) 50~90 50.2 72 75 107 92 88 PCT/(ng/mL) 0.05~0.50 0.09 0.17 0.15 0.17 0.15 0.08 LVEF/% 50~70 30 28 32 35 35 35 BNP/(pg/mL) 0~125 2 790 1 640 1 030 507 500 760 cTnI/(mg/L) 0.01~0.02 < 0.01 0.016 < 0.01 < 0.01 < 0.01 < 0.01 ECMO转速/(R/min) — 3 700 3 745 3 700 3 775 2 745 — ECMO血流速/(L/min) — 3.15 3.55 3.50 3.63 2.48 — ECMO氧流量/(L/min) — 3 3 3 2 2 — 注：LVEF：左心室射血分数。 
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