体外膜肺氧合中血液异物界面作用对凝血的影响与对策

doi:10.3969/j.issn.2095-378X.2017.02.013

外科研究与新技术 ›› 2017, Vol. 6 ›› Issue (2): 113-117.doi: 10.3969/j.issn.2095-378X.2017.02.013

体外膜肺氧合中血液异物界面作用对凝血的影响与对策

王瑜亮¹, 王琦²(综述), 张杨杨³(审校)

1.南京医科大学公共卫生学院卫生检验与检疫系,南京 211100;
2.南京医科大学第四临床医学院,南京 211100;
3.同济大学附属东方医院心脏大血管外科,上海 200120

收稿日期:2017-04-03 发布日期:2017-07-21
通讯作者: 张杨杨,电子信箱:zhangyangyang_wy@vip.sina.com
作者简介:王瑜亮(1995—),男,南京医科大学公共卫生学院2014级本科在读
基金资助:
江苏省“六大人才高峰”项目(2015WSW-019)

Effect and treatment of blood-material-interface interaction during extracorporeal membrane oxygenation

WANG Yuliang¹, WANG Qi², ZHANG Yangyang³

1.Department of Hygiene Analysis and Detection,School of Public Health,Nanjing Medical University, Nanjing 211100,China;
2.The Fourth School of Clinical Medicine,Nanjing Medical University,Nanjing 211100,China;
3.Department of Cardiovascular Surgery,East Hospital Affiliated to Tongji University, Shanghai 200102,China

Received:2017-04-03 Published:2017-07-21

摘要/Abstract

摘要： 体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)是一种可持久的体外气体交换和循环支持技术,广泛应用于各类重症患者的心肺支持治疗。ECMO应用中血液异物界面作用引起血浆蛋白吸附接触材料表面,激活凝血途径,造成凝血功能异常,引起出血、栓塞等并发症。全身使用抗凝药物,接触材料表面抗吸附涂层、抗凝药物释放涂层等方法部分缓解和解决了血液异物界面作用。新理念的提出和新技术的应用将进一步解决血液异物界面作用,提高ECMO的治疗效果。

关键词: 体外膜肺氧合, 血液异物界面作用, 凝血

Abstract: Extracorporeal membrane oxygenation (ECMO) is a sustainable technique with gas exchange and circulation support.It is extensively used in patients who are so severe that need cardiopulmonary support.Blood-material-interface interaction (BMII) during ECMO initiates adsorption between plasma proteins and material surface,activates blood coagulation pathway,and leads to coagulopathy and complications such as bleeding and thrombosis.Systematic application of anticoagulant drugs,anti-fouling coating on material surface,and anti-clotting drug release coating can partially relieve and solve the problem of BMII.Raising new concepts and developing new techniques will help reduce BMII and improve the therapentic effects of ECMO.

Key words: Extracorporeal membrane oxygenation, Blood-material-interface interaction, Coagulation

中图分类号:

R654.1

王瑜亮, 王琦, 张杨杨. 体外膜肺氧合中血液异物界面作用对凝血的影响与对策[J]. 外科研究与新技术, 2017, 6(2): 113-117.

WANG Yuliang, WANG Qi, ZHANG Yangyang. Effect and treatment of blood-material-interface interaction during extracorporeal membrane oxygenation[J]. Surgical Research and New Technique, 2017, 6(2): 113-117.

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体外膜肺氧合中血液异物界面作用对凝血的影响与对策

Effect and treatment of blood-material-interface interaction during extracorporeal membrane oxygenation

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