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体外膜肺氧合技术的进展与未来趋势
周光居
韩明帅
张茂
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DOI: 10.3760/cma.j.issn.1671-0282.2025.03.001
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摘要

体外膜肺氧合(extracorporeal membrane oxygenation, ECMO)作为当前最关键的生命支持技术之一,在危急重症的救治中发挥着不可替代的作用。其原理是将静脉血从体内引流至体外,经膜氧合器完成气体交换后再输回体内,可提供强大的呼吸、循环功能支持。按照血液回输的途径不同,可分为4种类型 [1]:(1)静脉-动脉体外膜肺氧合(venous-arterial extracorporeal membrane oxygenation, VA-ECMO),血液从静脉系统引出后注入动脉系统;(2)静脉-静脉体外膜肺氧合(veno-venous extracorporeal membrane oxygenation, VV-ECMO),血液从静脉引出又注回静脉;(3)静脉-肺动脉体外膜肺氧合(veno-pulmonary extracorporeal membrane oxygenation, VP-ECMO),血液从静脉引出注回肺动脉;(4)静脉-静脉动脉体外膜肺氧合(veno-venoarterial extracorporeal membrane oxygenation, VVA-ECMO),血液从静脉引出同时注回动脉和静脉系统。近年来,ECMO技术在创新材料与设备研发、人工智能技术融合、左心减压策略以及国产化等多方面取得进展,本文进行了系统阐述,以期为国内同行及研究者提供参考。

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周光居,韩明帅,张茂. 体外膜肺氧合技术的进展与未来趋势[J]. 中华急诊医学杂志,2025,34(03):275-279.

DOI:10.3760/cma.j.issn.1671-0282.2025.03.001

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体外膜肺氧合(extracorporeal membrane oxygenation, ECMO)作为当前最关键的生命支持技术之一,在危急重症的救治中发挥着不可替代的作用。其原理是将静脉血从体内引流至体外,经膜氧合器完成气体交换后再输回体内,可提供强大的呼吸、循环功能支持。按照血液回输的途径不同,可分为4种类型 [ 1 ]:(1)静脉-动脉体外膜肺氧合(venous-arterial extracorporeal membrane oxygenation, VA-ECMO),血液从静脉系统引出后注入动脉系统;(2)静脉-静脉体外膜肺氧合(veno-venous extracorporeal membrane oxygenation, VV-ECMO),血液从静脉引出又注回静脉;(3)静脉-肺动脉体外膜肺氧合(veno-pulmonary extracorporeal membrane oxygenation, VP-ECMO),血液从静脉引出注回肺动脉;(4)静脉-静脉动脉体外膜肺氧合(veno-venoarterial extracorporeal membrane oxygenation, VVA-ECMO),血液从静脉引出同时注回动脉和静脉系统。近年来,ECMO技术在创新材料与设备研发、人工智能技术融合、左心减压策略以及国产化等多方面取得进展,本文进行了系统阐述,以期为国内同行及研究者提供参考。
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