救命神器ECMO，为什么还没有国产化？

admin · 发表于 2020-10-14 12:35:53

                  <section data-role="paragraph" data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.png" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械媒体报道先锋</span></p><p><span>分享专业医疗器械知识</span></p></section><section><section><section><span>关注</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><p><br  /></p><section><section><section><section><section><section data-id="us705072"><section data-id="us702674"><section data-id="us702132"><section data-id="us702106"><section data-id="us702099"><section data-id="us678131"><section data-id="us678070"><section data-tools="gulangu" data-id="86131"><section><section data-width="100%"><section><p><span>本次新冠疫情当中，一种尖端技术被媒体反复提起，那就是人工肺（ECMO）。这种模拟人体心脏和肺脏的机器，可以对心肺疾病患者进行体外辅助呼吸，是一种协助治疗的手段，是重症患者最后的希望，是将患者从鬼门关抢回来的措施，于是，有人称ECMO是死神的对手。<strong>其原理为：将血液从静脉中抽出，流经膜肺氧合血红蛋白并清除二氧化碳，再将经过气体交换的血液输回患者体内</strong>。</span></p></section></section></section></section></section></section></section></section></section></section></section></section></section><section><br  /></section></section></section></section><section><section><p><img src="image/20201014/7c3e429c46b186db07b43e0591564af5_2.jpg" /></p></section><section><br  /></section></section><section><section><span>由于人工肺还未实现国产，患者一次使用的费用可能高达数万元，而在icu病房里动辄几十万元的使用费用更是让众多患者望而却步。真可谓“<strong>机器一响，黄金万两</strong>”。</span></section><section><span><br  /></span></section><p><iframe src="https://v.qq.com/iframe/player.html?width=500&height=375&auto=0&vid=l0942ychr4f&auto=0" width="100%" height="580" frameborder="0"></iframe></p><section><span>ECMO（体外膜肺氧合）</span></section><section><span>是如何为心脏或肺部提供生命急救支持的</span></section><section><br  /></section><section><span>那么，已经在2018年实现联合国工业目录全产业链工业化的中国，为何至今仍然只能依靠进口来购买“人工肺”？</span></section><section><br  /></section><section><strong><span>为什么我们面对已有的成品机器，不能照着模仿一下？图纸零件什么的都按照对方的比例造出来拼起来不就行了吗？</span></strong></section><section><span><br  /></span></section><section><br  /></section><section><p><img src="image/20201014/9c1a0b896144debf3c35224ef964436d_3.gif" /></p></section><section><br  /></section></section><section><section><span>真相当然不是这样的。请大家熟知以下原则：</span></section><section><br  /></section><ul><li><section><span>了解机器原理，不代表能造出来；</span></section></li><li><section><span>能在实验室里造出来1台，不代表能在工厂里大规模生产出来；</span></section></li><li><section><span>能在工厂里造出来，不代表能以市场接受的价格造出来；</span></section></li><li><section><span>能够以市场接受的价格造出来，不代表能卖得出去。</span></section></li></ul><section><br  /></section><section><span>以上就是某种工业产品从设计到制造到市场化的最简易过程。其中每前进一步，都意味着要克服巨大的困难和阻碍。</span></section><section><br  /></section><section><span>比如，了解某种产品的工作原理以后，要有专门的工业设计软件，用适当的材料，有懂得技术的工程人员，才能具备最基础的实验室制造条件；</span></section><section><br  /></section><section><span>再比如，实验室即使完成了原型机的打造，如何找出可以量产的机器，从而在工厂里来造这些机器？比如你在实验室里，<strong>找两个工程师在车床上车了一个零件安上去了</strong>。总不能也在车间里找两个工程师专门车零件吧？</span></section><section><br  /></section><section><span>最后，低成本，低能耗，低污染，收益的持续化，这些都是关键的坎，要一个一个跨过去。</span></section><section><br  /></section><section><strong><span>但不幸的是，我们国家现在，还卡在第一步。</span></strong></section><section><br  /></section></section><section><section><span>而这第一步当中最重要的门槛，就是<strong>机器的材料</strong>，这几乎是限制中国迈向高端制造业的致命法门。</span></section><section><br  /></section><section><span>以心肺机为例，<strong>这台机器其实其他部分都没有任何技术含量可言，生产原理也非常容易模仿。但其最核心的部分，是一种叫做人工膜肺的耗材，这个部分可以实现病人血液中的二氧化碳和空气中的氧气进行交换，这也是人体肺部呼吸的核心步骤。而这个步骤，是通过一种特殊材料来完成的，而且非永久使用，每隔一段时间就要更换。</strong></span></section><section><br  /></section></section><section><section><p><img src="image/20201014/db32b9703b7dc5f1a463fd221bea4bca_4.jpg" /></p></section></section><section><section><span>图中那个红色的方块状的东西，就是人工肺膜。</span></section><section><br  /></section><section><span>说到这里，可能你已经猜到了，是的，我们国家目前没有能力生产这种材料。</span></section><section><br  /></section><section><span>目前世界上能够生产人工肺的公司一共只有5家：<strong>其中2家在美国，2家在德国，1家在日本</strong>。5公司无一例外都将肺膜技术作为本公司的核心绝密技术而进行对外垄断。</span></section><section><br  /></section><section><strong><span>材料研发为什么这么难？</span></strong></section><section><br  /></section><section><span>我们不能用钱，用人去堆吗？不能集中力量办大事吗？</span></section><section><br  /></section><section><span>答案是不可以的。用一个通俗的比喻就是：一个女人生孩子需要10个月，那我如果现在给你10个女人，要你在1个月给我生个孩子，你能做到吗？</span></section><section><br  /></section><section><strong><span>其实意思就是，有些工业生产中的必要的步骤，是无法省掉的。</span></strong><span></span></section><section><br  /></section></section><section><section><span>回到材料的问题上来。</span></section><section><br  /></section><section><span>一个工业部件，要用什么材料，是有严格的工业标准的。以人工肺为例，要让某种材料完美模仿人体肺脏的功能，不能多也不能少，不能危及患者健康，还要能在工厂里以相对低廉的价格造出来，谈何容易。</span></section><section><br  /></section><section><span>寻找这种材料，需要不断设想，验证，再设想，再验证，每个参数，每个配比，每种工艺，都要通过无数次的试验才能得出来。</span></section><section><br  /></section><section><span>比如，你某次试验，配出了一种材料，但效果不够理想。那么，到底是哪个工艺流程顺序不对，还是当时的温度湿度不对，还是根本就是材料配比不正确？</span></section><section><br  /></section><section><span>对不起，只能再试。</span></section><section><br  /></section><section><span>这一试，也许就是几年，几十年。</span></section></section><section><section><br  /></section></section><section><section><span>所以，有关工业材料的各种参数和工艺流程，都是各个国家最最核心的军事级机密。外国人可以公布自己领导人的工资，但绝对不会告诉你某种尖端材料的工艺制备过程！</span></section><section><br  /></section><section><span>现在大家明白，<strong>为什么航空发动机，光刻机，光学镜片，芯片的国产化这么困难了吧？卡住我们的，几乎都是材料的问题</strong>。</span></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><br  /></p><p><span>来源：数字化企业</span></p><p><br  /></p></section></section></section></section></section><section data-role="outer" label="Powered by gulangu"><section data-role="paragraph" data-color="#757576"><section data-role="paragraph"><section><section><section data-brushtype="text"><strong>相关阅读</strong></section></section></section><section><section><br  /></section></section><section data-width="100%"><section><section><section><section data-width="100%"><section data-tools="gulangu" data-id="87578" data-color="#6aa9ad" data-custom="#59c3f9"><section><p><img src="image/20201014/2aac877ff9233ba5a66e7a5ff3a4febf_5.gif" 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