临时起搏器联合主动脉内气囊泵在21例急性心肌梗死患者中的应用  

Application of both temporary cardiac pacing and intra-aortic balloon pump in patients with acute myocardial infarction

作　　者：杨俊杰[1] 刘宏斌[1] 丁胜华[1] 张弢[1] 

机构地区：[1]解放军总医院心内科,北京100853

出　　处：《军医进修学院学报》2009年第1期70-72,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的:观察和评价急性心肌梗死患者中临时起搏器联合主动脉内气囊泵的运用。方法:回顾性研究我科2003年-2008年5月间因急性心肌梗死急诊治疗中联合使用临时起搏器和IABP的患者。结果:联合运用临时起搏器和IABP治疗急性心肌梗死患者21例,死亡10例,死亡率47.6%。死亡原因为严重难治性心源性休克6例,心脏破裂1例,感染并多脏器衰竭2例,其他原因1例。结论:临时起搏器联合主动脉内球囊反搏在治疗心肌梗死及缓慢性心律失常患者心梗所致心源性休克患者时仍存在较高死亡率。尿量、血管活性物质过多使用、EF值是增加死亡风险的预测因素。Objective： To observe the curative effect and safety of temporary cardiac pacing （TPI） and intra-aortic bal- loon pump （IABP） and to discuss the relative factors for mortality in patients with acute myocardial infarction （AMI） after treatment with TPI and IABP. Methods： Twenty-one patients with AMI treated with both TPI and IABP in our department from 2003 to 2008 were retrospectively analyzed. Multivariate logistic regression analysis was performed to determine the relative factors for mortality. Results： Ten out of the 2l patients died with a mortality rate of 47.6%. The causes of death were found to be severe refractory cadiogenic shock, infection complicated by multiple organ failure, refractory ventricular arrhythmia, and cardiac rupture, etc. Multivariate logistic regression analysis showed that cardiac function and urine output could predict the risk of death. Conclusion： Treatment with TPI and IABP can result in a high mortality rate of patients with AMI. Urine output （ 〈0.5mL· kg^-1 ·h^-1 ） , excessive use of vasoactive substances such as dopamine, ejection fraction value （ 〈40% ） are the predicting factors for the risk of death.

关 键 词：心肌梗死 主动脉球内气囊泵 心脏起搏器 人工 死亡率 

分 类 号：R541.4[医药卫生—心血管疾病]