关键词: 心脏缺损, 先天性, 肺动脉高压, 体外膜肺氧合作用, 继发纤溶亢进, 危重病护理

Abstract: To summarize the nursing experience of hyperfibrinolysis during extracorporeal membrane oxygenation （ECMO） therapy in a puerpera with congenital heart disease. In view of the rapid progression of the disease,the patient could not be immediately treated with surgery,and the veno-arterial ECMO（VA-ECMO） assisted supportive treatment was used,during which the patient‘s coagulation system was abnormally activated and secondary hyperfibrinolysis occurred. Nursing points included early warning of VA-ECMO hyperfibrinolysis,rapid and seamless replacement of ECMO oxygenator,target volume-oriented capacity management,individualized nursing with the puerperal as the main body. ECMO oxygenator replacement was the difficulty and focus of this case. After careful treatment and nursing,the patient‘s condition tended to be stable. ECMO was successfully removed on the 38th day supported by VA-ECMO,and tracheal intubation was successfully removed on the 41st day after admission. The patient‘s condition was stable and discharged after 72d admission.

Key words: Heart Defects, Congenital, Pulmonary Arterial Hypertension, Extracorporeal Membrane Oxygenation, Secondary Hyperfibrinolysis, Critical Care Nursing