主动脉内球囊反搏术在高危冠心病患者介入治疗中的应用  

Application of intra-aortic balloon pump among high-risk patients undergoing percutaneous coronary intervention with coronary artery disease

作　　者：马根山[1] 陈忠[1] 冯毅[1] 汤成春[1] 沈成兴[1] 罗丹[1] 戴启明[1] 童嘉毅[1] 丁建东[1] 

机构地区：[1]东南大学附属中大医院心内科,江苏南京210009

出　　处：《现代医学》2009年第6期429-431,共3页Modern Medical Journal

摘　　要：目的评价主动脉内球囊反搏术(IABP)对行介入治疗的高危冠心病患者的有效性、患者并发症和住院病死率影响。方法52例高危冠心病患者应用IABP作血流动力学支持,分为择期血运重建组(n=20)和急诊血运重建组(n=28,其中4例进行保守治疗),比较两组临床特征、治疗效果和住院期间不良心血管事件。结果两组患者平均年龄、体重指数及合并高血压、糖尿病比例差异无统计学意义,急诊血运重建组合并心力衰竭、心源性休克比例显著高于择期血运重建组(P<0.01)。IABP平均时间为(82.2±18.0)h,总有效率为86.5%(45/52)。院内病死率为11.5%(6/52)。急诊血运重建组4例死于心源性休克,4例行保守治疗患者中2例死于多器官功能衰竭。18例心源性休克患者中4例(22.2%)死亡。结论IABP与冠脉血管重建术联合治疗高危冠心病患者,可降低住院病死率,提高手术安全性。Objective To assess intra-aortic balloon pump （IABP） on effectiveness, morbidity and death in hospital among high-risk patients undergoing coronary revascularization. Methods Fivty-two patients with high risk coronary artery disease （CAD） inserted with IABP were divided into elective revascularization group （n = 20）, urgent revascularization group （n = 28,4 of them were given conservative treatment）. The clinical characteristics, therapy effectiveness and adverse cardiovascular events in hospital were compared between different groups. Results Patients in urgent revasculization group had higher ratio of heart failure and cardiac shock compared with patients in elective revasclarization group （P 〈 0.01 ）. Mean time usage of IABP was （82.2 ± 18.0） h,with effective ratio of 86.5% （45/52） and mortality of 11.5% （6/52）. Four patients died of cardiac shock in urgent revascularization group and 2 patients given conservative treatment died of multiple organ failure. Conclusion Coronary revasclarization combined with IABP support could decrease in-hospital death risk in high-risk CAD patients and improve procedural safety during coronary intervention.

关 键 词：主动脉内球囊反搏术 冠心病 高危 冠状动脉血管重建术 

分 类 号：R541.4[医药卫生—心血管疾病]