急性心肌梗死泵衰竭患者急诊IABP的循环支持治疗  

Efficacy of emergency intra-aortic balloon pump(IABP) support in patients with pump failure complicated by acute myocardial infarction

作　　者：蒋国平[1] 屈百鸣[2] 王慧[2] 杨向红[2] 蒋世平 严影[2] 张美齐[2] 张可[2] 孙仁华[2] 周跃[2] 

机构地区：[1]浙江大学医学院附属第二医院急诊科,杭州310009 [2]浙江省人民医院 [3]东阳市虎鹿医院

出　　处：《中华急诊医学杂志》2004年第6期397-399,共3页Chinese Journal of Emergency Medicine

摘　　要：目的　评价急性心肌梗死泵衰竭患者经急诊主动脉内气囊反搏术 (intra aorticballoonpump ,IABP)循环支持治疗的可行性及其疗效。方法　急性心肌梗死并发泵衰竭的患者一经确诊即予急诊IABP循环支持治疗 ,以同时期同一疾病未经IABP治疗的患者作为对照组进行比较 ,观察其循环复苏前后的血压、心率、心功能、脏器功能不全的发生数、 30天病死率等变化。结果　两组间年龄、性别、院前时间、冠状动脉病变支数、再发心梗次数及IABP治疗前心功能分级 (Killip s分级 )、收缩压、舒张压差异无显著性 ;IABP循环支持治疗后较治疗前患者收缩压、舒张压、心功能分级明显提高 ,心率明显下降 ;治疗组较对照组器官功能不全发生数和 30天病死率减低有非常显著意义。结论　对急性心肌梗死并发症泵衰竭患者在急诊尽早进行IABP治疗具有明显的循环支持治疗效果 ,以便为进一步的治疗争取时间并能明显减少并发症、降低病死率。Abstract Objective To observe the efficacy of emergency intra-aortic balloon pump(IABP) support in the patients with pump failure complicated by acute myocardial infarction(AMI).Methods Forty-six patients with pump failure complicated by AMI were separated to group 22 patients treated by IABP support and a controll group of 24 patients without IABP support. The two groups were compared for systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate, Killip's grade, morbidity of organ dysfunction,and 30 days' mortality.Results No significant differences were noted between two groups with regard to the age, gender,time of pre-hospital, location of AMl, and Killip's grade, SBP,and DBP before IABP.The SBP ,DBP and Killip's grade after IABP in the patients treated group were significantly improved than those before IABP. The heart rate after IABP, mortidity of organ dysfunction and 30 days' mortality of in the IABP-treated patients were obviously lower than those without IABP. Conclusion The early use of IABP in the Emeregency department in patients with pump failure after AMI has obviously been improved survival rate and reduced complications

关 键 词：急性心肌梗死 泵衰竭 急诊 IABP 循环支持 治疗 主动脉内气囊反搏术 

分 类 号：R542.22[医药卫生—心血管疾病]