主动脉内球囊反搏支持下急性心肌梗死的急诊介入治疗  

Application of intraaortic balloon counterpulsation during primary percutaneous coronary intervention in patients with cardiogenic shock complicating with acute myocardial infarction

作　　者：朱莹[1] 项美香[1] 马骥[1] 王建安[1] 

机构地区：[1]浙江大学医学院附属二院心内科,杭州310009

出　　处：《中华急诊医学杂志》2007年第12期1255-1259,共5页Chinese Journal of Emergency Medicine

摘　　要：目的探讨主动脉内球囊反搏支持下的急性心肌梗死合并心源性休克患者行急诊介入治疗的可行性、安全性及疗效。方法回顾性分析浙江大学医学院附属第2医院2005年9月至2007年2月确诊急性心肌梗死合并心源性休克,在主动脉内球囊反搏支持下行急诊介入治疗的患者27例,观察血流动力学改变、急诊介入治疗特点、住院期间及术后1个月的病死率、主要心脏不良事件、心功能恢复状况。结果应用主动脉内球囊反搏30 min后血流动力学即开始改善,2～6 h达血流动力学稳定。27例患者在主动脉内球囊反搏支持下均成功完成急诊介入治疗,无术中死亡,住院期间死亡2例,随访1个月死亡1例。术后1个月的左室射血分数和室壁运动评分均较术后第1天显著改善。结论主动脉内球囊反搏支持下的急诊介入治疗能显著提高急性心肌梗死合并心源性休克患者的生存率,显著改善心肌梗死后的心功能状态。Objective To investigate the safety, efficacy and effects of emergent pereutaneous coronary intervention （PCI） in patients from Second Affiliated Hospital, Medical College, Zhejiang University with cardiogenic shock （CS） complicating acute myocardial infarction （AMI）. Method Twenty-seven patients with CS complicating with AMI were treated by PCI with intraaortic balloon counterpulsation （IABP） support. The change of hemodynamics before and after IABP and PCI, the characteristics of PCI, the mortality during hospitalization, the major adverse cardiac events （MACE） and left ventricular ejection fraction at 30- day follow- up were observed. Results The hemodynamics were significantly improved after IABP. No patients died during PCI. Two patients died after PCI and tire total mortality was 7.4% in hospital. During the period of 30 - day follow- up, one patient died of heart failure. The left ventricular ejection fraction greatly improved at 30 days after PCI. Conclusions The data suggested that the use of IABP during PCI in patients with CS complicating AMI was safe, decreased mortality and improved prognosis.

关 键 词：急性心肌梗死 心源性休克 主动脉内球囊反搏 血管成形术 经腔 经皮冠状动脉 

分 类 号：R542.22[医药卫生—心血管疾病]