探讨体外膜肺氧合(ECMO)技术在产科危重症患者救治中的应用。

选择2020年1月1日至2025年5月31日于深圳市人民医院使用ECMO救治的6例危重孕产妇为研究对象。采用回顾性分析方法，对这6例孕产妇的临床资料进行分析，总结ECMO适应证、并发症及母儿预后等。本研究经深圳市人民医院医学伦理委员会批准(审批文号：LL-KY-2026273-01)。

本研究6例孕产妇ECMO使用指征包括心源性休克1例，剖宫产术中误吸导致重症肺炎1例，肺动脉高压危象3例及心搏骤停1例。5例产妇使用静脉-动脉(VA)-ECMO，1例使用静脉-静脉(VV)-ECMO；ECMO启用时间分别为分娩前(2例)、分娩时(1例)、分娩后(3例)。ECMO治疗期内，并发症包括肺炎(3例)、因左下肢缺血坏死而行截肢术(1例)、肺出血(2例)、消化道出血伴气道出血(1例)，动静脉瘘(右侧股浅动脉与右侧大隐静脉)伴穿刺点切口感染、双下肢肌力减退(1例)。这6例患者中，1例为双胎妊娠，其余5例为单胎妊娠；患者住院时间为28~126 d，中位住院时间为71.5 d；产妇结局包括：5例患者康复出院，1例患者死亡，死亡原因为肺动脉高压危象；新生儿结局包括：1例为死胎，其余6例均活产，并经新生儿科积极救治均预后良好。

ECMO有助于降低危重孕产妇死亡率，为进一步救治提供保障。

To explore the application of extracorporeal membrane oxygenation (ECMO) technology in the treatment of critically ill obstetric patients.

Six critically ill pregnant women treated with ECMO at Shenzhen People′s Hospital from January 1, 2020, to May 31, 2025, were selected as the study subjects. A retrospective analysis was conducted on the clinical data of the six cases to summarize ECMO indications, complications, and maternal and fetal outcomes. This study was approved by the Medical Ethics Committee of Shenzhen People′s Hospital (Approval No. LL-KY-2026273-01).

The indications for ECMO in this study included one case of cardiogenic shock, one case of severe pneumonia caused by aspiration during cesarean section, three cases of pulmonary hypertension crisis, and one case of cardiac arrest. Five cases used venoarterial (VA)-ECMO, while one case used venovenous (VV)-ECMO. The ECMO initiation times were 2 cases before delivery, 1 case during delivery, and 3 cases after delivery. Complications during ECMO treatment included three cases of pneumonia, one case of amputation due to ischemic necrosis in the left lower limb, two cases of pulmonary hemorrhage, one case of gastrointestinal bleeding accompanied by airway bleeding, and one case of arteriovenous fistula (superficial femoral artery and great saphenous vein on the right side) with incision infection at the puncture site, and decreased muscle strength in both lower limbs.Among the six patients, one case was with a twin pregnancy, and the other five were singleton pregnancy. The hospitalization duration for the six patients ranged from 28 to 126 days, with a median of 71.5 days. Regarding maternal outcomes, five patients recovered and were discharged, while one died due to pulmonary hypertension crisis. The neonatal outcomes were one stillbirth, and the remaining six were live births, all of whom recovered well with active neonatal treatments.

ECMO helps to reduce the mortality rate of critically ill pregnant women and provides a foundation for further treatment.