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目的:总结县级manbet官网登录 独立开展体外膜肺氧合辅助心肺复苏（extracorporeal cardiopulmonary resuscitation, ECPR）治疗成人心脏骤停(cardiac arrest, CA)患者的经验和效果。方法:回顾天台县人民manbet官网登录 从2020年1月至2023年10月23例成人CA-ECPR治疗的临床资料，收集心脏骤停患者初始心律、ECMO启动时间、CA-Pump On时间(即心脏骤停至ECMO开始转流的时间)、ECMO启动-Pump On时间(即ECMO启动至ECMO开始转流的时间)、ECMO置管-Pump On时间(即ECMO穿刺置管至ECMO开始转流的时间)、并发症、神经功能预后、病死率、存活率等数据，进行分析比较。并收集分析2020年1月至2023年10月期间33例具有ECPR指征但仅接受传统心肺复苏（conventional cardiopulmonary resuscitation, CCPR）的成人CA患者的病死率、存活率，与CA-ECPR进行比较。结果:23例CA-ECPR患者，自主心律恢复16例，死亡15例，好转出院8例，其中6例神经功能预后良好。与CA-CCPR相比，CA-ECPR患者病死率明显下降(65.21% vs. 90.91%, P=0.017)，存活率明显提升（34.78% vs. 9.09%, P=0.017）。在ECPR流程逐渐优化后，2022—2023年组与2020—2021年组相比，存活率显著提升（46% vs. 20%），ECMO启动-Pump On时间[41（ IQR 36.5~44.5）min vs. 43（ IQR 32.75~58.5）min, P=0.709]、ECMO置管-Pump On时间[30（ IQR 24.0~37.0）min vs. 33（ IQR 27.25~55.00）min, P=0.575],均有下降，但两组差异无统计学意义。存活组与死亡组比较，初始可电击心律比例明显高于死亡组（75% vs. 20%），CA-Pump On时间[61（ IQR 49.25~69.25）min vs. 69（ IQR 58.0~89.0）min, P=0.287]、ECMO启动-Pump On时间[39( IQR 29.25~51.75)min vs. 43( IQR 34.0~52.0)min， P=0.539）]均低于死亡组，但两组差异无统计学意义。 结论:县级基层manbet官网登录 独立开展ECPR治疗成人心脏骤停，有利于提高县域内心脏骤停患者的抢救成功率，改善患者预后，在县级manbet官网登录 推广心脏骤停ECPR抢救技术，可使更多的心脏骤停患者获益，具有重要意义及较高的可行性。

Objective:To summarize the experience and outcomes of independent extracorporeal membrane oxygenation (ECMO) assistance for adult cardiac arrest patients conducted by a county-level hospital.Methods:Clinical data of 23 adult cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) at Tiantai County People's Hospital from January 2020 to October 2023 were retrospectively reviewed. Data, including initial cardiac rhythm, ECMO initiation time, cardiopulmonary resuscitation (CA)-Pump On time, ECMO initiation-Pump On time, ECMO cannulation-Pump On time, complications, neurological function prognosis, mortality rate, and survival rate, were collected and analyzed. Collect and analyze the mortality and survival rates of 33 adult cardiac arrest (CA) patients meeting the criteria for extracorporeal cardiopulmonary resuscitation (ECPR) but receiving only conventional cardiopulmonary resuscitation (CCPR) from January 2020 to October 2023, and compare these rates with those of patients who underwent CA-ECPR.Results:Among the 23 cardiac arrest patients, 16 patients achieved spontaneous heart rhythm recovery, 15 patients experienced death, and 8 patients showed improved conditions upon discharge, with 6 patients exhibiting good neurological function prognosis. Compared to CA-CCPR, patients who received CA-ECPR showed a significant decrease in mortality rate (65.21% vs. 90.91%, P=0.017) and a significant increase in survival rate (34.78% vs. 9.09%, P=0.017). After gradual optimization of the ECPR process, the 2022-2023 group showed a significantly increased survival rate compared to the 2020-2021 group(46% vs. 20%). ECMO initiation-Pump On time [41( IQR36.5-44.5)min vs.43( IQR32.75-58.5)min, P=0.709] and ECMO cannulation-Pump On time[30( IQR24.0-37.0)min vs. 33( IQR27.25-55.00)min, P=0.575] decreased, although the differences between the two groups were not statistically significant. In the comparison between survival and death groups, the proportion of initial shockable rhythm was significantly higher in the survival group (75% vs. 20%). CA-Pump On time [61( IQR49.25-69.25)min vs.69( IQR58.0-89.0)min, P=0.287]and ECMO initiation-Pump On time[39( IQR29.25-51.75)min vs.43( IQR34.0-52.0)min, P=0.539] were lower in the survival group, but the differences were not statistically significant. Conclusions:Independent implementation of ECPR for adult cardiac arrest at the county-level primary hospital improves the success rate of resuscitation and enhances patient prognosis. The promotion of ECPR rescue technology in county hospitals is feasible and significant, benefiting a larger population of cardiac arrest patients.