主动脉内球囊反搏抢救急性心肌梗死后室间隔穿孔患者的疗效分析  

Analysis of clinical features and prognosis in patients with ventricular septal rupture complicating acute myocardial infarction

作　　者：方臻飞[1] 黄亿源[1] 胡信群[1] 沈向前[1] 唐建军[1] 李江[1] 吕晓玲[1] 赵延恕[1] 周胜华[1] 胡连根 

机构地区：[1]中南大学湘雅二医院心内科,湖南长沙410011 [2]新余市中医院,江西新余338025

出　　处：《中国急救医学》2014年第2期149-152,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨主动脉内球囊反搏（IABP）抢救急性心肌梗死（AMI）后发生室间隔穿孔（VSR）患者的疗效及作用.方法 对我院心内科2007-07~2012-04收治的20例急性ST段抬高性心肌梗死（STEMI）并室间隔穿孔患者的临床资料进行回顾性分析.结果 20例AMI合并室间隔穿孔患者均给予药物治疗,其中14例药物治疗的同时给予IABP支持,其即刻血流动力学改善率为57.1%,3例行介入封堵术,2例行外科手术治疗,均存活;1例病情稳定出院,其余6例于住院期间死亡.结论 IABP在抢救AMI后VSR患者时能够暂时稳定患者血流动力学,为手术争取时间,最终降低病死率,是手术前重要的过渡手段.Objective To explore the effects of intra- aortic balloon pump （IABP） in patients with ventricular septal rupture （VSR） complicating acute ST - segment elevation myocardial infarction （STEMI）. Methods The clinical experience and data of 20 post - infarct VSR patients from July 2007 to April 2012 in our hospital were retrospectively analyzed. Results Among the 20 patients with ventrieular septal rupture complicating acute myocardial infarction （AMI）, IABP was used in 14 patients. Surgery or transeatheter closure was respectively performed in 5 patients of the 14 ones, and all of them survival. The other 15 （70%） patients died. Conclusion When treating patients with ventricular septal rupture complicating AMI, IABP should be a transition means by maintaining the patients＇hemodynamic stable for a long time, which would improve the survival rate.

关 键 词：急性心肌梗死(AMI) 室间隔穿孔(VSR) 主动脉内球囊反搏(IABP) 

分 类 号：R654.2[医药卫生—外科学]