临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (9): 708-.doi: 10.3969/j.issn.1000-3606.2019.09.018

• 综合报道 • 上一篇    下一篇

联合体外膜肺治疗川崎病休克综合征1 例报告并文献复习

赵坚,谢利剑,肖婷婷,李筠, 姜逊渭   

  1. 上海交通大学附属儿童医院心内科(上海 200062)
  • 发布日期:2020-01-16
  • 通讯作者: 谢利剑 电子信箱:naijileix@aliyun.com

Combined extracorporeal membrane oxygenation in the treatment of Kawasaki disease shock syndrome:  a case report and literature review

ZHAO Jian, XIE Lijian, XIAO Tingting, LI Yun, JIANG Xunwei   

  1. Department of Cardiology, Children's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200062, China
  • Published:2020-01-16

摘要: 目的 探讨体外膜肺(ECMO)治疗危重川崎病休克综合征合并心源性休克的临床价值。方法 回顾分析1 例川崎病休克综合征合并心源性休克患儿的临床特点,以及ECMO治疗的过程,并复习相关文献。结果 患儿,女, 4岁。 确诊为川崎病,静脉滴注丙种球蛋白(IVIG)治疗无反应。病程第6天出现腹泻,精神萎靡,血压下降及呼吸、心血管、消化、 肾脏系统多器官功能障碍,给予液体复苏后病情仍危重,符合ECMO心脏支持建议指征。经联合静脉-动脉模式体外膜肺 治疗后病情缓解,顺利出院。结论 川崎病休克综合征合并心源性休克时,尽早联合ECMO支持治疗也许是有效方法之一。

关键词: 川崎病; 休克综合征; 心源性休克; 消化道感染; 体外膜肺氧合

Abstract: Objective To explore the clinical value of extracorporeal membrane oxygenation (ECMO) in the treatment of severe Kawasaki disease shock syndrome (KDSS) complicated with cardiogenic shock. Methods The clinical characteristics of KDSS complicated with cardiogenic shock in a child and the process of treatment with ECMO were retrospectively analyzed, and the related literature was reviewed. Results A 4-year-old girl diagnosed with Kawasaki disease did not response to intravenous gamma globulin (IVIG) therapy. Diarrhea, listlessness, decreased blood pressure and multiple organ dysfunction of respiratory, cardiovascular, digestive and renal systems occurred on the 6th day of the course of the disease. The condition was still critical after fluid resuscitation, which was in line with the recommended indications of ECMO cardiac support. After the treatment of veno-arterial (V-A) mode ECMO, the patient's condition was relieved and discharged. Conclusion Early combined ECMO support therapy may be one of the effective methods for KDSS with cardiogenic shock.

Key words: Kawasaki disease; shock syndrome; cardiogenic shock; digestive tract infection; extracorporeal membrane oxygenation