植入主动脉内球囊反搏的33例急性心肌梗死患者的临床分析  

Clinical analysis of 33 patients with acute myocardial infarction implanted with intra-aortic balloon counterpulsation

作　　者：王翔飞[1] 王齐兵[1] 葛雷[1] 钱菊英[1] 张峰[1] 颜彦[1] 刘学波[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科,上海市心血管病研究所,上海200032

出　　处：《上海医学》2010年第7期641-643,共3页Shanghai Medical Journal

基　　金：国家十一五科技支撑计划项目资助(2006BAI01A04)

摘　　要：目的分析33例植入主动脉内球囊反搏(IABP)的急性心肌梗死患者的临床资料,探讨IABP使用的方法。方法回顾性分析2006年1月—2009年7月复旦大学附属中山医院心内科所有植入IABP的急性心肌梗死患者的临床资料。结果男27例(82%),女6例(18%),平均年龄为(68.9±11.3)岁。急性前壁心肌梗死22例,急性下壁心肌梗死8例。全因病死率为64%(21/33),17例患者在血流动力学稳定后脱机,其中5例死于多种并发症。IABP植入的中位时间为48h。5例患者发生血小板减少,3例死亡,死亡原因均与出血无关。6例患者床旁植入IABP,无并发症。8例患者发生急性肾功能不全或慢性肾功能不全急性加重,6例死亡。结论 IABP辅助使得多数急性心肌梗死患者的血流动力学趋于稳定,但是住院期间的病死率仍难以令人满意。床旁IABP植入易行。Objective To analyze the clinical data of 33 patients with acute myocardial infarction （AMI） implanted with intra-aortic balloon counterpulsation （IABP）,so as to study the application of IABP. Methods The clinical data of 33 myocardial infarction patients implanted with IABP were reviewed retrospectively. Results Twenty-seven （82%） of the patients were male; the mean age of patients was （68.9±11.3） years old. Twenty-two patients had anterior infarction and 8 had inferior infarction. All-cause mortality was 64% （21/33）. Seventeen patients achieved stable hemodynamic situation,then with intra-aotic balloon removed successfully; however,five of them finally died from other complicating diseases. The median duration of IABP support was 48 hours. Six patients had received prompt bedside insertion without any severe complications. Eigth patients had acute renal failure or acute aggravation of chronic renal failure and 6 of them died. Conclusion Although most of the patients assisted by IABP support can achieve stable hemodynamics,the in-hospital mortality remains high. The implantation of IABP at bedside is feasible.

关 键 词：心肌梗死 主动脉内球囊反搏 急性肾功能不全 

分 类 号：R542.22[医药卫生—心血管疾病]