2025 年第 5 期 第 20 卷

体外膜氧合辅助下急诊经皮冠状动脉介入治疗急性心肌梗死合并心源性休克患者的最新进

Recent progress of extracorporeal membrane oxygenation assisted emergency percutaneous coronary intervention in the treatment of patients with acute myocardial infarction complicated with cardiogenic shock

作者：王正泷1李豪1陈明1张睿辰1李磊2李子军2刘效波2

英文作者：Wang Zhenglong1 Li Hao1 Chen Ming1 Zhang Ruichen1 Li Lei2 Li Zijun2 Liu Xiaobo2

单位：1山东第二医科大学临床医学院，潍坊261000；2山东第二医科大学附属医院心血管外科，潍坊261035

英文单位：1Clinical Medical School Shandong Second Medical University Weifang 261000 China; 2Department of Cardiovascular Surgery Affiliated Hospital of Shandong Second Medical University Weifang 261035 China

关键词：体外膜氧合；经皮冠状动脉介入；急性心肌梗死；心源性休克

英文关键词：Extracorporealmembraneoxygenation;Percutaneouscoronaryintervention;Acutemyocardialinfarction;Cardiogenicshock

• 摘要：

• 急性心肌梗死合并心源性休克是一种严重且危及生命的病症，死亡率较高。近年来，体外膜氧合（ECMO）辅助下急诊经皮冠状动脉介入（PCI）的治疗模式在该类患者的救治中取得了一定进展。ECMO能够为患者提供有效的心肺支持，维持循环稳定，为急诊PCI创造条件。近期临床上多学科协作不断加强，多个医疗中心成功开展了ECMO辅助下的急诊PCI手术，显著提高了患者的生存率及预后。此外，随着技术的不断发展，对于ECMO辅助急诊PCI的治疗时机、适应证把握以及术后并发症的管理等方面也有了更深入的研究和认识。然而，该治疗模式仍面临诸多挑战，如高昂的治疗费用、技术操作的复杂性以及可能引发的并发症等问题仍有待进一步解决。本综述对近年ECMO联合PCI治疗急性心肌梗死合并心源性休克的相关研究作一总结，以进一步提高该治疗模式的有效性和安全性，为患者带来更多的生存希望。

• Acute myocardial infarction complicated by cardiogenic shock is a serious and life-threatening condition with high mortality. In recent years, emergency percutaneous coronary intervention (PCI) assisted by extracorporeal membrane oxygenation (ECMO) has made some progress in the treatment of these patients. ECMO can provide effective cardiopulmonary support for patients, maintain circulatory stability, and create conditions for emergency PCI. Recently, multidisciplinary cooperation has been strengthened in clinical practice, and several medical centers have successfully carried out ECMO-assisted emergency PCI, which has significantly improved the survival rate and prognosis of patients. In addition, with the continuous development of technology, there are more in-depth studies and understandings on the treatment timing, indications and postoperative complications management of ECMO-assisted emergency PCI. However, this treatment mode still faces many challenges, such as high treatment cost, technical complexity and possible complications, which still need to be further solved. This review summarizes the recent studies on ECMO combined with PCI in the treatment of acute myocardial infarction complicated with cardiogenic shock, in order to further improve the effectiveness and safety of this treatment mode, and bring more survival hope for patients.