主动脉内球囊反搏在高危冠状动脉旁路移植手术中的预防性应用  

Preventive use intra-aortic balloon pump in high-risk patients with coronary artery bypass grafting surgery

作　　者：高泉鑫[1] 龚庆成[1] 李嘉维[1] 刘岸新[1] 孙志全[1] 赵岩岩[1] 缪娜[1] 邢家林[1] 贾在申[1] 陈彧[1] 刘晓军[1] 

机构地区：[1]首都医科大学附属北京安贞医院体外循环科,100029

出　　处：《中华胸心血管外科杂志》2009年第1期20-22,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨主动脉内球囊反搏（IABP）在高危冠状动脉旁路移植术（CABG）围术期预防性应用的效果。方法41例高危cABG病人围术期应用IABP辅助，其中20例为预防性应用（Y组），21例为CABG围术期发生严重低心排被迫应用（B组）。术前两组性别、年龄、体表面积、心功能、射血分数、病变程度基本一致，仅冠心病合并室壁瘤情况，Y组显著高于B组（70％对38．1％P=0．04）。结果Y组与B组生存率为95．0％对85．7％（P=0．31），IABP应用时间为（72．5±28．91）h对（97．47±47．70）h，（P=0．02），术中严重低血压或心律失常发生率5％对66．7％（P〈0．0001）。术后呼吸机应用时间（22．0±1．6）h对（39．6±2．1）h（P=0．005）、ICU停留时间（58．0±1．5）h对（98．5±1．9）h（P=0．003）。结论IABP的预防性应用为高危CABG病人提供了安全保障，术中严重低血压或心律失常发生率低，病情恢复快。Objective To determine the importance of preventive use of intranortie balloon pump （IABP） in high-risk patients underwent coronary artery bypass grafting （CABG） surgery. Methods 41 high-risk CABG patients were divided into two groups determined by the time of IABP onset. 21 patients （control group, CG） were with cardiac event occurred, 20 patients （pre-use group, PG） were preventive use of IABP. The eharacterastics of the two groups were no significant different except the percentage of ventricular anemysm （70% in PG versus 38.1% in CG, P=0.04）. Results More patients in PG survived than thosein CG （95.0% versus 85.7 %, P = 0.31 ）. Significantly prolonged duration of IABP in CG was explored （ 72.5 ± 28.91 ） hours in PG versus （ 97.47 ± 47.70） hours in CG, P =0.02. The hypotension or arhythmia were significant lower in PG during operation （5% in PG versus 66.7% in CG, P 〈 0.0001）. The patients in PG had significantly short ventilator support time [ （22.0 ± 1.6） hours versus （39.6 ± 2.1） hours, P=0.005] and intensive care unit （ICU） stay [（58.0±1.5） hours versus （98.5± 1.9） hours, P=0.003]. Conclusion Preventive use of IABP in high-risk patients underwent CABG can support safety. It may reduce hypotension or arhythmia during operation.

关 键 词：冠状动脉分流术 手术期间 主动脉内气囊泵 手术后并发症 

分 类 号：R686[医药卫生—骨科学]