人工膜肺氧合器临床应用研究及发展趋势

本文综述目前我国膜式氧合器临床应用，人工膜肺领域的研究成果和发展趋势。通过问卷调查形式显示我国近年CPB （Cardiopulmonary Bypass,体外循环）技术发展迅速，膜式氧合器应用量逐年升高，应用ECMO（extracorporeal membrane oxygenation, 体外膜肺氧合）辅助循环的比例显著增加。人工膜肺多方面研究进展包括：为新生儿体外循环设计的婴幼儿膜式氧合器，整合 动脉滤过器与超滤设备的小型化氧合器，这些设计可以明显减少体外循环回路整体表面积和预充量，避免CPB 中过度血液稀释， 降低或不用输入红细胞。同时减轻由于血液与人工材料接触诱发的炎性反应。人工膜肺在人工材料改进和结构设计有很显著发 展，通过改进气体交换的人工膜材料，优化结构设计，提高血液抗凝能力和耐受力，设计出如ECMO 可以长时间应用于辅助循环 来延续和支持病人的生命。对膜式氧合器的试验研究的相关进展和展望也会在本文讨论。

Development and Clinical Application of Artificial Lungs

The article reviews the recent clinical application of oxygenator in China, and the development in the field of artificial lungs. It can be found based survey that the CPB technology is rapidly progressing, the number of artificial lungs used is significantly increased, and the rate of using in ECMO cases shows a marking increase compared to the total number of artificial lungs used. The researches on oxygenator include the oxygenator intended solely for the neonatal CPB patient; oxygenators with integrated arterial filters and ultrafiltration (UF) devices, which can obviously reduce the prime volumes and surface areas of the whole CPB circuit, and also can attenuate CPB-associated hemodilution and decrease or eliminate the need for homologous red blood cells during CPB. Meanwhile, this may decrease CPB-related inflammation. Artificial membrane lung has significant development in the improvement of artificial materials and structural design. By improvement of the gas exchange capabilities of artificial membrane materials, and the optimization design and the increase of the anticoagulant blood and tolerance ability, the artificial membrane is designed such as ECMO, which can be used in circulation assistant to support the patient''s life.