主动脉内球囊反搏治疗心脏瓣膜置换术后低心排综合征的疗效比较  

Efficacy of intra-aortic balloon counter-pulsation in low cardiac output syndrome after cardiac valve replacement： a comparative study

作　　者：赵元[1] 周新民[1] 唐浩[1] 胡建国[1] 刘立明[1] 李建明[1] 刘锋[1] 陈艳[1] 

机构地区：[1]中南大学湘雅二医院心胸外科湖南省心血管病研究所,长沙410011

出　　处：《中华生物医学工程杂志》2010年第3期252-254,共3页Chinese Journal of Biomedical Engineering

摘　　要：目的比较主动脉内球囊反搏（IABP）治疗单纯主动脉瓣狭窄及其他心脏瓣膜病换瓣术后低心排综合征疗效的差异，探讨提高心脏瓣膜病IABP治疗效果的可行途径。方法回顾性分析2004年6月至2009年1月本科室心脏瓣膜置换术后出现低心排综合征21例患者的临床资料，均采用经皮股动脉穿刺法行IABP治疗。其中单纯主动脉瓣狭窄患者10例，其他瓣膜病患者11例，比较2组IABP治疗的成功率。因低心排综合征致无法脱离体外循环术中紧急置入IABP10例，其余11例均为术后在重症监护病房（ICU）紧急置入，比较2组IABP治疗的成功率。结果21例换瓣术后低心排综合征患者IABP治疗成功11例。IABP对单纯主动脉瓣狭窄患者及其他心脏瓣膜病患者换瓣术后低心排综合征的治疗成功率分别为90．0％（9／10）和18．2％（2／11），前者明显高于后者（P〈0．05）。术中和术后IABP置入的成功率分别为80．0％（8／10）和27．3％（3／11），术中IABP置入的成功率明显高于术后（P〈0．05）。结论针对性地尽早应用IABP有望提高其对心脏瓣膜置换术后低心排综合征的疗效。Objective To compare the efficacy ofintra-aortic balloon counter-pulsation （IABP） for low cardiac output syndrome （LCOS） after aortic valve replacement in aortic valve stenosis vs other valvular diseases, so as to improve the outcomes of IABP in valvular heart diseases. Methods Data of 21 patients who suffered from LCOS after cardiac valve replacement in our department from June 2004 to January 2009 were reviewed. These patients were given IABP with percutaneous puncture of femoral artery for treatment of simple aortic valve stenosis （n=10） and other valvular diseases （n=l 1）. The successful rate of IABP was compared between these two cohorts. Meanwhile, the successful rate of IABP was also compared between patients who suffered from LCOS and received emergent intraoperative IABP due to difficulty weaning from cardiac bypass （n=10） and those who received IABP in ICU after valve replacement （n=ll）. Results Eleven of 21 patients experienced successful IABP treatment. The successful rate of IABP was 90.0% （9/10） for simple aortic valve stenosis vs 18.2% （2/11） for other valvular diseases （P〈0.05）, 80.0% （8/10） for intraoperative IABP vs 27.3% （3/11 ） for postoperative IABP （P〈0.05）. Conclusion Early target IABP can be useful in improving the outcome of postoperative LCOS in patients with valve replacement.

关 键 词：反搏动术 泵 主动脉内气囊 主动脉瓣狭窄 心脏瓣膜假体植入 治疗结果 

分 类 号：R654.2[医药卫生—外科学]