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目的:分析超重或肥胖对静脉-动脉体外膜肺氧合(VA ECMO)辅助的女性患者临床结局的影响。方法:总结2011年1月至2014年12月,在北京安贞医院接受VA ECMO辅助的女性患者48例,按体质量指数(BMI)高低分为未超重组(NOW),BMI<24/(kg/m~2),n=34和超重或肥胖组(OVO),BMI≥24/(kg/m~2),n=14,比较两组患者ECMO辅助前基本资料、ECMO辅助参数、并发症和患者的临床结局。结果:两组患者的年龄、相关基础病、ECMO辅助前心功能、是否心肺复苏及ECMO前乳酸水平均无明显差别。OVO组患者的出院生存率为42.9%,高于NOW组的14.7%(P<0.05),两组患者的ECMO辅助时间和输血量没有明显差别,住院时间、ICU(intensive care unit)时间、机械通气时间均无明显差异。结论:超重或肥胖的VA ECMO辅助女性患者出院生存率可能高于偏瘦的患者,应辩证看待肥胖对VA ECMO辅助的女性患者临床结局的影响。
OBJECTIVE: To analyze the effect of overweight or obesity on clinical outcomes in women with venous-arterial adventitia and pulmonary oxygenation (VA ECMO). Methods: From January 2011 to December 2014, 48 female patients assisted by VA ECMO in Beijing Anzhen Hospital were divided into two groups based on NOW body mass index (BMI), BMI <24 / ( kg / m ~ 2), n = 34 and overweight or obesity group (OVO), BMI≥24 / (kg / m ~ 2), n = 14.The ECMO auxiliary parameters and ECMO auxiliary parameters of two groups were compared Symptoms and patient’s clinical outcome. RESULTS: There was no significant difference in age, underlying underlying disease, ECMO-assisted anterior cardiac function, cardiopulmonary resuscitation, and pre-ECMO lactic acid levels between the two groups. The discharge survival rate of patients in OVO group was 42.9%, which was 14.7% of that in NOW group (P <0.05). There was no significant difference in ECMO time and blood transfusion, hospital stay, intensive care unit (ICU) time, Ventilation time no significant difference. CONCLUSION: The discharge survival rate of overweight or obese VA ECMO-assisted women may be higher than that of overweight women. The clinical effect of obesity on VA ECMO-assisted female patients should be dialectical.