冠心病手术方式对IABP应用的影响  

Effect of Operation Program of Coronary Heart Disease on Application of Intra-Aortic Balloon Pump

作　　者：王升声[1] 万峰[1] 江龙[1] 廖忠凯[1] 刘晓飞 高峰[1] 

机构地区：[1]邮电总医院,北京100032

出　　处：《中国微创外科杂志》1999年第3期8-11,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的:探讨冠心病手术方式对主动脉内球囊反搏(intra-aortic balloon pump,IABP)的影响。方法;冠心病手术176例,27例为非体外循环心脏跳动下的手术。在149例体外循环(cardio-pulmonary bypass,CPB)下的手术中,单纯冠状动脉搭桥(coronary artery bypass grafting,CABG)35例,CABG+激光心肌血管重建(Transmyocardial Laser Revascularization,TMLR)联合手术114例,其中29例加做室壁瘤切除、室间隔穿孔修补、瓣膜置换手术,9例于术中安置临时心外膜起搏器。结果:149例体外循环下的手术中共置入IABP23例,其中120例常规手术组中应用IABP15例,29例有附加手术组中应用IABP8例,而27例非体外循环下的手术中无IABP的应用。结论:(1)应用LABP数量在常规手术组与术中加做室壁瘤切除、瓣膜置换术或成型术、室间隔穿孔修补术(p<0.05),安置临时心外膜起搏器(P<0.01),组比较结果均有统计学意义;(2)激光心肌血管重建术,无论与何种冠心病手术联合应用,无论激光打孔数量多少,都没有增加IABP的应用;(3)未发现冠脉搭桥数量与IABP有关。Objective:To study the relation between operation procedures and application of intra-aor-tic balloon pump (IABP). Methods: 176 cases were treated by coronary artery bypass grafting(CABG)or CABG with transmyocardial laser revascularization (TMLR),among them, 149 cases were operated on with cardio-pulmonary bypass (CPB), 27 cases without CPB, and 114 cases were underwent CABG + TMLR and 35 cases were underwent CABG alone. 29 of them also had ventricular aneurysm resection (VAR) .ventricular septal defect repaire (VSDR)and valvular replacement (VR). Apart from this, 9 cases of them had temporary pacemaker placement (TPP). Results:IABP was used in 23 cases in CPB group. Off-pump coronary artery bypass(OPCAB) could significantly decrease the use of IABP. Conclusions: (1) There were statistically significant difference between traditional operation group and complicated procedures group (with VAR, VSDR, VR ond TPP) in regard to using IABP. (2)TMLR had no effect to increase the use of IABP, whatever it combined with the method of coronary operation or the number of laser channels. (3)The number of bypass grafts were not related to the application of IABP.

关 键 词：主动脉内球囊反搏术 冠状动脉搭桥术 激光心肌血管重建术 体外循环 

分 类 号：R654.2[医药卫生—外科学]