心脏手术围术期主动脉内球囊反搏的临床应用  

Peri-Operative Application of Intra-Aortic Balloon Pump in Cardiac Surgery

作　　者：房勤[1] 张玉海[1] 谷天祥[1] 王春[1] 卢春茂[1] 师恩祎[1] 

机构地区：[1]中国医科大学附属第一医院心脏外科,辽宁省沈阳市110001

出　　处：《中国循环杂志》2010年第4期299-301,共3页Chinese Circulation Journal

摘　　要：目的:探讨主动脉内球囊反搏(IABP)在心脏手术围术期危重患者应用的临床效果。方法:我院2006-01至2009-12对83例心脏外科手术患者实施了IABP,其中术前诊断单纯冠心病62例,冠心病合并瓣膜病6例,冠心病合并室壁瘤2例,瓣膜病8例,法乐四联症2例,房间隔缺损+室间隔缺损1例,慢性缩窄性心包炎2例。术前置入球囊6例,术中共置入球囊67例,术后在监护室置入10例。结果:83例置入IABP患者术后30天内总死亡率30.12%(25/83),其中冠心病死亡率27.14%(19/70),非冠心病死亡率46.15%(6/13),非冠心病死亡率高于冠心病死亡率,差异有统计学意义(P<0.05)。冠心病术前置入IABP死亡1例,术中置入IABP死亡13例,术后置入IABP死亡5例。结论:IABP能明显改善心脏手术围术期低心排患者的血流动力学指标,选择合适的时机应用IABP,能够提高IABP的疗效,降低危重患者的死亡率。Objective ：To investigate the role of peri-operative implantation of intra-aortic balloon pump （IABP） in high risk patients during the cardiac surgery. Methods ： A total of 83 patients received IABP from January 2006 to December 2009 in our hospital during the peri-operation period of cardiac surgery. The patients included 62 of coronary artery bypass grafting （CABG）,6 of CABG combined with valve replacement,2 of CABG and ventricular aneurysm resection, 8 of valve replacement,2 of Tetralogy of Fallot repair, 1 of atrial and ventricular septal defect repair and 2 of chronic pericardial resection. In all patients, 6 of them received IABP before the open chest operation,67 received IABP during the operation, and 10 had the implantation at ICU after the operation. Results ：The total mortality rate of IABP implantation within 30 days was 30.12% （25/83）. The death of coronary heart dis- ease （CHD） was 27. 14% （19/70） and the death of non-CHD was 46.15% （6/13） ,the difference had the statistic meaning （ P 〈 0. 05 ）. In CHD patients, pre-operational IABP implantation death occured in 1 case. in-operational implantation death was in 13 cases and post-operation death was in 5 cases. Conclusion： IABP could improve the hemodynamics during the peri-operation of cardiac surgery in patients with low cardiac output syndrome and reduce the mortality in high risk patients. It was important to perform IAPB in proper timing.

关 键 词：主动脉内球囊反搏 心脏外科手术 围术期 

分 类 号：R54[医药卫生—心血管疾病]