主动脉球囊反搏治疗心源性休克的影响因素分析  

Analysis of influencing factors for intra-aortic balloon counterpulsation on treatment of cardiogenic shock

作　　者：方志成[1] 郑翔[1] 陈黎[1] 刘伯毅[1] 盛春风[1] 黄云飞[1] 王福珍[1] FANG Zhi-cheng ZHENG Xiang CHEN Li LIU Bo-yi SHENG Chun-feng HUANG Yun-fei WANG Fu-zhen(Department of Intensive Care Unit,Affiliated Taihe Hospital of Hubei Medicinal Colleg)

机构地区：[1]湖北医药学院附属十堰市太和医院重症医学科,湖北十堰442000

出　　处：《心血管康复医学杂志》2016年第5期532-535,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨影响主动脉球囊反搏(IABP)治疗心源性休克疗效的因素。方法:选择138例采用IABP治疗的心源性休克患者,统计心源性休克病因、心肌梗死部位、心腔大小、心源性休克发生至开始IABP治疗时间、机械通气应用等因素,以2周内各种原因死亡为研究终点,评估上述因素对IABP临床治疗效果的影响。结果:与心肌梗死、冠脉旁路移植术后患者相比,中毒性心肌炎、风湿性心瓣膜病患者行IABP的死亡率明显升高(26.2%、12.9%比86.4%、66.7%,P均<0.05);与前间隔、广泛前壁和高侧壁梗死患者相比,下壁并右室心肌梗死患者行IABP的死亡率明显升高(10.0%、13.0%、11.1%比78.9%,P<0.05);此外,心脏越大、机械通气时间越长、IABP应用越晚,死亡率越高(P均<0.05)。结论:中毒性心肌炎、风湿性心瓣膜病,下壁并右室心肌梗死,主动脉球囊反搏应用延迟及心脏大、机械通气等因素可影响主动脉球囊反搏临床效果,值得警惕。Objective：To explore clinical influencing factors for intra-aortic balloon counterpulsation（IABP）on treatment of cardiogenic shock.Methods：A total of 138 cases with cardiogenic shock undergoing IABP were selected.Causes of cardiogenic shock,myocardial infarction（MI）site,heart chamber size,onset-to-IABP time and mechanical ventilation etc.were collected.All-cause death within two weeks was regarded as then endpoint of study.Influence of above factors on therapeutic effect of IABP were assessed.Results：Compared with patients after MI and CABG,there were significant rise in mortality（26.2%,12.9% vs.86.4%,66.7%）in those with toxic myocarditis and rheumatic valvular disease undergoing IABP,P〈0.05all;compared with patients with anterior septum,wide anterior wall and high sidewall MI,there was significant rise in mortality（10.0%,13.0%,11.1% vs.78.9%）of those with inferior wall complicated right ventricular MI undergoing IABP,P〈0.05;In addition,larger heart size,longer mechanical ventilation time and late IABP use can lead to higher mortality（P〈0.05 all）.Conclusion：Toxic myocarditis and rheumatic valvular disease,myocardial infarction sites on inferior wall and right ventricular,delayed IABP application,bigger heart and mechanical ventilation time etc.can affect IABP therapeutic effect,in this regard we should be vigilant.

关 键 词：主动脉气囊 心肌梗死 休克 心源性 

分 类 号：R542.22[医药卫生—心血管疾病]