主动脉内球囊反搏在高危急性心肌梗死中的应用  

Application of intra-aortic balloon pump in the treatment of patients with high-risk acute myocardial infarction

作　　者：张戟[1] 徐亚伟[1] 陈艳清[1] 李伟明[1] 于学靖[1] 侯磊[1] 徐剑刚[1] 

机构地区：[1]同济大学附属铁路医院心血管内科,上海200072

出　　处：《新乡医学院学报》2004年第5期357-359,共3页Journal of Xinxiang Medical University

摘　　要：目的　评价主动脉内球囊反搏 (IABP)在高危急性心肌梗死 (AMI)紧急血循环重建治疗中的临床疗效与安全性。方法　 35例确诊高危AMI ,2 6例并发心源性休克 ,13例同时合并心源性休克和急性左心衰 ,均经常规药物治疗无效 ,行IABP和紧急血循环重建治疗。结果　 35例中 ,狭窄冠脉≥ 2支者 34例 ,另 1例为左主干完全闭塞。 2 9例 38支狭窄血管进行经皮冠状动脉成形术 ,共置入 2 4个支架 ;6例行冠状动脉旁路移植术。 2 3例经上述治疗后病情稳定 ;12例死亡。其中 2例因球囊堵塞提前拔除反搏泵 ,1例因股动脉血肿形成进行了外科手术。结论　IABP置入在高危AMI患者 ,尤其是合并心源性休克者的紧急血循环重建治疗中安全、有效 ,能显著改善血流动力学 ,减少心血管不良事件。Objective To evaluate the clinical efficacy and the safety of intra-aortic balloon pump (IABP) for the emergency reconstruction of blood circulation in patients with high-risk acute myocardial infarction (AMI).Methods Thirty-five patients,suffered from high-risk AMI,26 patients complicated with cardiogenic shock,and 13 patients complicated with cardiogenic shock and acute left-heart failure simultaneously.All of these patients was no effect by administration of conventional medical treatment,and the IABP and emergency reconstruction of blood circulation were used.Results Among of 35 patients,34 patients had coronary stenoses≥2 branch,and the other one patient had a completely obstructive left main coronary artery.The percutaneous transluminal coronary angioplasty (PTCA) was performed in 38 constrictive coronary in 29 patients.Other six patients were taken cornonary artery bypass graft (CABG).After treatment of above mentioned,23 patients were clinically stable and 12 patients died.In 12 died patients,the pump were pulled out ahead of time in 2 patients because of obstruction,and one patient was underwent an operation because of the femoral arterial haematoma.Conclusion Using IABP in the reconstruction of blood circulation in high-risk AMI patients,especially those who complicated with cardiogenic shock,can be effective and safe.It can obviously improve the hemodynamic parameters and decrease adverse events of cardiogenic disease.

关 键 词：急性心肌梗死 心源性休克 主动脉内球囊反搏 血循环重建 

分 类 号：R954.22[医药卫生—药学]