IABP对CABG术中乳内动脉旁路血流量的影响  

Effect of intra-aortic balloon pumping on blood flow in LIMA graft in coronary artery bypass grafting

作　　者：胡瑞荣[1] 马旭东[1] 郑慧萍[1] 高峰[1] 高文德[1] 郝兴海[1] 杨碧波[1] 

机构地区：[1]北京大学第三医院心脏外科,北京100083

出　　处：《中国现代医学杂志》2007年第21期2666-2669,共4页China Journal of Modern Medicine

摘　　要：目的研究IABP对CABG术中LIMA-LAD血流量的影响,以观察IABP的辅助效能。方法回顾60例IABP辅助下行CABG手术患者,术中使用TTFM直接测量并记录LIMA-LAD旁路血流波形曲线及PI值,分别记录反搏前后的旁路平均流量,进行自身对比研究。结果左乳内动脉旁路灌注呈现舒张期为主的单相灌注曲线。在未使用IABP时,LIMA-LAD旁路平均血流量为(30.15±10.30)mL/min,PI值为(2.89±0.81)。使用IABP后,旁路的平均血流量增加为(36.38±12.87)mL/min(P<0.01),PI值升高为(3.12±0.67)(P=0.184)。使用IABP可使LIMA-LAD旁路血流量增加约20.5%。结论IABP可显著增加LIMA-LAD旁路的血流灌注。[Objective] To evaluate the effect of intra-aortic balloon pump （IABP） on the blood flow in the left internal mammary artery（LIMA） graft to left anterior descending artery（LAD） in coronary artery bypass graft（CABG）. [Methods] We collected the data of blood flow in LIMA graft from 60 patients （from Sept. 2003 to Mar. 2006） who underwent CABG with LIMA to LAD. IABP was used for all of them preoperatively. All grafts were tested intraoperatively with transit time flow measurement （TTFM）. ECG, blood pressure and the graft flow curves were recorded during the measurement,and the blood flow of each cardiac cycle was recorded separately. Paired-Samples tests were used to compare variables between on-IABP and off-IABP. [Results] Blood stream of LIMA graft flowed mainly during diastolic phase with minimal systolic peaks taking place during the ventricular contraction. Data was expressed as the mean＋SD （standard deviation）. Without IABP assistance the mean flow value of LIMA to LAD was （30.2±10.3） mL/min, the PI value was （2.89±0.81）. When IABP assistance was on the mean blood flow increased to （36.4±12.9） mL/min （P 〈0.01）. The PI value rised to （3.12±0.67） （P =0.184）. The mean flow in LIMA to LAD graft increased about 20.5% with IABP assistance. [Conclusion] IABP can significantly increase the blood flow in LIMA to LAD graft.

关 键 词：主动脉内球囊反搏 冠状动脉旁路移植术 旁路血流量 

分 类 号：R654[医药卫生—外科学]