8月27日，全球使用体外膜肺氧合（ECMO）时间最长的新冠肺炎患者于广州医科大学附属第一医院康复出院。62岁的刘先生，不仅经历了新冠肺炎感染，而且使用ECMO辅助支持长达111天、气管插管呼吸机通气150天。
当日，钟南山院士亲自前来看望刘先生。看着他健康的笑容，钟南山院士开玩笑说刘先生最大的收获是减肥。刘先生却认真地表示，最重要的是医生们给了他生命。
图源：青蜂侠
High quality technologies, strong teamwork and humanistic care have contributed to the successful treatment of a critically ill COVID-19 patient at the First Affiliated Hospital of Guangzhou Medical University in Guangdong province.
The novel coronavirus patient survived after a world record 111 days on an extracorporeal membrane oxygenation machine. The patient, who also had relied on a respirator to breathe for over 150 days, was discharged from the hospital last Thursday. He was the first COVID-19 patient to recover after having been on an ECMO machine for so long.
2020年8月27日，广州，钟南山院士介绍111天ECMO患者救治情况。图源：人民视觉
钟南山院士评价这个病例时说，“我们知道一般外科抢救或呼吸衰竭综合征的病人，用ECMO的时间一般都不会太长，坚持一两个月就是奇迹了，而这位病人ECMO上了111天。我在与国外同行交流时，他们也惊奇于能够在这么长时间克服了出血、凝血、感染3个大关。”
他还说道，“为了人民的生命健康和生命安全，我们可以不惜一切代价，在这个病人身上充分体现出来了。”
视频来源：南方视频
Zhong Nanshan, a top respiratory disease expert and an academician at the Chinese Academy of Engineering, said many of his foreign counterparts said it was a medical "miracle" for a seriously ill COVID-19 patient to recover after being on an ECMO for 111 days.
Zhong said they never gave up on the man, and Zhong himself asked about the patient's condition every day. "As long as there is a glimmer of hope, we do it at all costs," Zhong said.
那么ECMO究竟是什么呢？戳视频，看21世纪英文报美国主持人Larura揭秘“人工肺”ECMO↓↓↓
ECMO指的是体外膜肺氧合。主要用于对重症心肺功能衰竭患者提供持续的体外呼吸与循环，以维持患者生命。
ECMO is short for extracorporeal membrane oxygenation. It is a machine used to replace heart and lung function in open-heart surgery. In simple words, it allows the heart and lungs to rest, by pumping and oxygenating a patient's blood outside the body.
今年1月底，从武汉探亲返回广州的刘先生被确诊为新冠肺炎，转入广州市第八人民医院。由于刘先生病情急转直下，即使给予积极无创辅助通气，呼吸衰竭仍进行性恶化。
图源：青蜂侠
广医一院重症医学科黎毅敏教授、刘晓青主任对刘先生进行了会诊。考虑到他的病情已经发展成为急性呼吸窘迫综合征（ARDS)，2月4日，刘先生被转入重症医学科。
最让他们犯愁的是，刘先生身高不到1米69，体重却足足95公斤，属于病理性肥胖的范畴。据以往经验，病理性肥胖危重症患者救治难度非常大，且刘先生又是一位新冠病毒感染者，免疫功能低下，可以说是“难上加难”。2月9日，刘晓青主任和团队讨论后决定：立即进行ECMO支持。
图源：青蜂侠
“当时他全身出现浮肿，再加上本身就肥胖，给我们的操作带来了很大难度。”医生刘冬冬说。晚上11点多，ECMO开始运转。有了“魔肺”的支持，刘先生的外周血氧饱和度首次达到100%。
图源：青蜂侠
The patient, who was transferred to the First Affiliated Hospital of Guangzhou Medical University from another local hospital on Feb 4, was sent to the intensive care unit and connected to the ECMO on Feb 9 when his condition worsened. In addition to providing medication, the medical staff took turns caring for and looking after him in the ward.
Liu Xuesong, the doctor in charge of the patient, said the man was overweight and had cardiovascular disease, high blood pressure, sleep apnea and other health problems, making treatment more difficult. The patient, at 169 centimeters tall, weighed over 95 kilograms.
尽管医护人员精心守护，但是由于病理性肥胖的ARDS患者没有可参考的治疗方案，又遇到了未知的新冠病毒，不仅引起严重的肺部感染，而且对凝血系统造成很大的打击，刘先生成为了广医一院ICU里“最难啃的骨头”。
挺过了最初“黑暗”的3个月，刘先生的病情有了好转的迹象。5月29日，这是个让广医一院ICU团队难忘的日子，在ECMO支持111天后，刘先生终于撤下了膜肺。又经过一个多月的精心治疗，刘先生非常争气，病情一直向好。7月2日，持续150天的气管插管终于等到了拔除的那一刻。
2020年8月27日，广州，钟南山院士团队到病房看望111天ECMO患者。图源：人民视觉
视频来源：青蜂侠
目前，刘先生是全球ECMO支持时间最长并成功撤机的新冠肺炎患者。团队能够将这块“硬骨头”啃下来，在刘晓青主任看来，归根结底就是“用心”二字。“不仅要让他们活着，更要有质量地活着，这才是一名合格的重症医生。”
刘冬冬医生介绍，团队每天给刘先生至少做两次康复锻炼，松解关节及肌肉，“为了帮他活动一条腿，我们至少需要4个医生和1个护士，一起帮他抬起来、再放下……每次都要循环多次。”
图源：青蜂侠
"Humanistic care is the soul of healing patients," said Liu Xiaoqing, director of the hospital's intensive care medicine unit.
Liu Dongdong, another doctor said the staff took turns helping the patient with rehabilitation exercises twice a day to prevent his joints from stiffening and his muscles from atrophying.
Liu Xiaoqing said while preserving life is the most basic requirement, medical staff also should have the patient's future in mind. "We should not only enable them to live, but also live with quality," she said.
正是在这样精心的护理下，尽管刘先生卧床一百多天，没有发生一处压疮。昨日，在医护人员的欢送下，重获新生的老刘终于可以平安离院回家了。
综合来源：央视新闻、羊城晚报、南方视频、广州日报、China Daily
