中国实用儿科杂志

中国实用儿科杂志 ›› 2025, Vol. 40 ›› Issue (12): 1049-1052.DOI: 10.19538/j.ek2025120616

• 病例报告 • 上一篇    下一篇

重症百日咳体外膜氧合治疗死亡病例3例报告

  

  1. 浙江大学医学院附属儿童医院心衰/机械辅助循环科 国家儿童健康与疾病临床医学研究中心 国家儿童区域医疗中心，浙江  杭州  310052
  • 出版日期:2025-12-06 发布日期:2026-01-09
  • 通讯作者: 林茹，电子信箱：6184009@zju.edu.cn

Report on three death cases of severe pertussis treated with ECMO

  1. National Clinical Research Center for Children’s Health and Disease，National Children’s Regional Medical Center，Department of Body and Heart Failure/Mechanical Assisted Circulation，Children’s Hospital Affiliated to Zhejiang University School of Medicine，Hangzhou  310052，China
  • Online:2025-12-06 Published:2026-01-09

摘要：

收集2024年1月至4月，浙江大学医学院附属儿童医院应用体外膜氧合（extracorporeal membrane oxygenation，ECMO）治疗的重症百日咳3例死亡病例资料。3例患儿3月龄7 d 至4月龄8 d，均于ECMO前存在中重度肺动脉高压，且合并其他病原感染。ECMO支持时间为124 h、27 h、192 h，均未成功撤离ECMO，原发疾病未有效控制前合并不可逆急性肾损伤1例及脑梗死1例。重症百日咳患儿因百日咳毒素等因素导致白细胞数急剧升高，引发急性肺动脉高压，病死率高。ECMO可作为危重百患儿的挽救性治疗，且应在循环衰竭前尽早启动。

关键词:

Abstract: Three death cases of severe pertussis treated with extracorporeal membrane oxygenation（ECMO） from January to April 2024 were collected. Among the 3 children aged 3 months and 7 days to 4 months and 8 days，all had moderate to severe pulmonary hypertension before ECMO and were complicated with other pathogen infections. The ECMO support times were 124 hours,27 hours and 192 hours respectively. There was one case of irreversible acute kidney injury and one case of cerebral infarction before the primary disease was effectively controlled. Children with severe pertussis have extremely high white blood cell count due to pertussis toxin and other factors，leading to acute pulmonary hypertension，and the mortality is high. ECMO can be used as a rescue treatment for children with severe pertussis，and ECMO should be initiated as early as possible before circulatory failure occurs.

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