主动脉内球囊反搏在心脏外科中的预防性应用及抗凝策略  

The strategy of prophylactic application of Introaortic balloon pump and anticoagulation therapy in cardiac surgery

作　　者：沈冬焱[1] 王学鹏[1] 何子林 解基严[2] 万峰[2] 

机构地区：[1]凤凰医疗集团北京市健宫医院心血管外科,100054 [2]北京大学第三医院心血管外科

出　　处：《北京医学》2012年第7期532-534,共3页Beijing Medical Journal

摘　　要：目的探讨主动脉内球囊反搏(IABP)的应用时机和使用中抗凝的方法。方法回顾性分析239例次心脏手术围手术期IABP的临床应用方法以及并发症资料。结果本组抢救性应用88例次(36.8%,)预防性应用140例次(58.6%),治疗心绞痛8例(3.3%),治疗心律失常3例(1.3%)。总体死亡率21.1%,总体IABP相关并发症为8.7%。应用IABP期间针对IABP进行肝素抗凝99例次,未针对IABP进行抗凝140例次。两组下肢缺血性并发症发生率差异无统计学意义(P=0.31)。结论 IABP不仅是急性左心功能衰竭的抢救手段,更是一种积极的治疗方法,没有针对IABP采用肝素抗凝并未增加相关下肢缺血性并发症。Objective To discuss the prophylactic application of IABP and associated anticoagulation strategy in patients with heart surgery. Methods The clinical methods and complications of IABP perioperatively in 239 cases from 2001 to 2011 were analyzed. Results In our study, rescue IABP were performed in 88 cases （36.8%）, preventional IABP were performed in 140（ 58.6%）patients, and 8 IABP （3.3%） were performed for angina pectoris, 3 were done for arrhythmia. The total mortality rate was 21.1%. During the IABP procedure, 99 patients received anticoagulation with heparin and 140 patients had non anticoagulation. In these two groups, there was no difference in lower limbs ischemic complications （P = 0.31）. The total incidence of complications was 8.7%. Conclusion IABP is not noly a lifesaving method in acute left heart failure, but also an aggressive therapeutic method. Associated ischemic complications in lower limbs may not be increased without heparin anticoagulation therapy.

关 键 词：主动脉内球囊反搏 适应证 抗凝治疗 

分 类 号：R654.2[医药卫生—外科学]