主动脉内球囊反搏在主动脉瓣轻、轻中度反流患者中的应用  

Application of Intra-aortic Balloon Pump in Patients with Mild or Mild to Moderate Aortic Regurgitation

作　　者：刘浩[1] 丁芳宝[1] 黄健兵[1] 汤敏[1] 杨琦[1] 冯肖媛[1] 梅举[1] 

机构地区：[1]上海交通大学医学院附属新华医院心胸外科,上海200092

出　　处：《中国胸心血管外科临床杂志》2012年第1期48-51,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：上海市科委资助项目(09491964400)~~

摘　　要：目的探讨主动脉内球囊反搏(IABP)在主动脉瓣轻度和轻中度反流患者中使用的有效性和安全性。方法回顾性分析2006年9月至2011年1月上海交通大学医学院附属新华医院心脏手术后15例主动脉瓣轻中度反流伴左心室射血分数(LVEF)显著减低(<40.00%)患者行IABP辅助的临床资料,其中男11例,女4例;平均年龄63.60(50～74)岁。主动脉瓣轻度反流9例,轻中度反流6例,LVEF均<40.00%。术后放置IABP,比较患者使用IABP前后的平均动脉压(MAP)、心脏指数(CI)、全身血管阻力指数(SVRI)、肺循环阻力指数(PVRI)、LVEF、主动脉瓣反流等指标。结果本组患者无死亡,患者使用IABP后CI较术前明显改善,差异有统计学意义[(3.30±0.29)L/(min.m2)vs.(1.99±0.23)L/(min.m2),t=48.30,P=0.00],LVEF高于使用IABP前,差异有统计学意义(37.20%±1.37%vs.42.60%±2.87%,t=11.34,P=0.00),SVRI较使用IABP前改善,差异也有统计学意义[(2 347.00±190.00)dyn s/(cm5 m2)vs.(2 128.00±204.00)dyn s/(cm5.m2),t=20.60,P=0.00],主动脉瓣反流未见明显增加(χ2=0.60,P=0.44)。结论对主动脉瓣轻度和轻中度反流伴LVEF显著减低患者心脏手术后进行IABP辅助具有明显的循环支持效果,且未增加主动脉瓣反流的风险。Objective To estimate the effectiveness and safety of intra-aortic balloon pump（IABP）in the patients with mild or mild to moderate aortic regurgitation.Methods A total of 15 patients with mild or mild to moderate aortic regurgitation and low left ventricular ejection fraction（LVEF 40.00%） including 11 males and 4 females,who underwent IABP application after cardiac surgery between September 2006 and January 2011,were included in this study.Their age ranged from 50 to 74 years with an average age of 63.60 years.There were 9 patients with mild aortic regurgitation and 6 patients with mild to moderate aortic regurgitation,all with LVEF 40.00%.IABP catheters were inserted before operation and IABP worked after heart the recovery of heart beat.Mean aortic pressure（MAP）,cardiac index（CI）,systemic vascular resistance index（SVRI）,pulmonary vascular resistance index（PVRI）,LVEF,and aortic regurgitation volume before the use of IABP and after stopping use of it were compared.Results The total mortality was zero.The patients’ CI significantly improved from 1.99±0.23 L/（min.m2） to 3.30±0.29 L/（min.m2） after IABP（t =48.30,P=0.00）.Their LVEFs were significantly improved after use of IABP（37.20%±1.37% versus 42.60%±2.87%,t =11.34,P=0.00）.Their SVRI improved significantly（2 347.00±190.00 dyn.s/（cm5.m2） versus 2 128.00±204.00 dyn.s/（cm5.m2）,t=20.60,P=0.00）after use of IABP.However,their aortic regurgitation volume were not significantly increased（χ2=0.60,P=0.44）.Conclusion Application of IABP in patients with mild or mild to moderate aortic regurgitation and low LVEF can obtain good circulation support after operation without increasing their aortic regurgitation.

关 键 词：主动脉内球囊反搏 主动脉瓣反流 左心室射血分数 心脏指数 

分 类 号：R654.2[医药卫生—外科学]