ECMO联合IABP、CRRT成功救治暴发性心肌炎合并心脏电风暴1例

张豪; 王艳玲; 范振兴; 李博宇; 王宇彬; 孔强; 武德崴; 宋菲; 郭呈龙; 王秀玲; 敬馥宇; 刘马超; 夏经钢; 尹春琳

doi:10.13201/j.issn.1001-1439.2024.12.016

ECMO联合IABP、CRRT成功救治暴发性心肌炎合并心脏电风暴1例

- 首都医科大学宣武医院心脏内科国家老年疾病临床医学研究中心(北京，100053)

详细信息

通讯作者: 夏经钢，E-mail：xiajinggang@sina.cn

中图分类号: R542.2

收稿日期: 2023-12-09

刊出日期: 2024-12-13

ECMO combined with IABP and CRRT successfully treated a patient with fulminant myocarditis combined with cardiac electrical storms: one case report

- Department of Cardiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Centre for Geriatric Diseases, Beijing, 100053, China

More Information

Corresponding author: XIA Jinggang, E-mail: xiajinggang@sina.cn

Received Date: 09 December 2023

Publish Date: 13 December 2024

摘要

摘要: 本文报道1例因反复恶性心律失常、电风暴和心源性休克为主要临床特点确诊暴发性心肌炎的患者。应用ECMO、IABP、呼吸机和CRRT联合辅助进行生命支持，糖皮质激素抗炎、免疫球蛋白调节免疫状态，以及抗凝、镇静镇痛、抗心律失常、低温脑保护、脱水降颅压、抗感染及营养支持等综合救治下，患者病情好转后出院。
- 暴发性心肌炎 /
- 心脏电风暴 /
- 生命支持治疗
Abstract: This article reports a patient diagnosed with fulminant myocarditis due to the main clinical features as recurrent malignant arrhythmias, electrical storms, and cardiogenic shock. The patient was discharged from the hospital after his condition improved with the application of ECMO, IABP, ventilator and CRRT combined with assisted life support, glucocorticoid anti-inflammatory, immunoglobulin to regulate the immune status, as well as anticoagulation, sedation and analgesia, antiarrhythmia, hypothermia cerebral protection, dehydration to lower the cranial pressure, anti-infective and nutritional support and other comprehensive rescue treatments.
- fulminant myocarditis /
- cardiac electrical storm /
- life support treatment

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图 1 入院后心电图的动态演变过程

Figure 1. Dynamic evolution process of ECG after admission

下载: 全尺寸图片幻灯片

图 2 患者起病至ECMO辅助期间心肌损伤标志物的变化

Figure 2. Changes in myocardial injury markers during the period from onset to ECMO assistance in patients

下载: 全尺寸图片幻灯片

参考文献(8)

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