术前应用主动脉球囊反搏在高危冠心病患者非体外循环冠状动脉搭桥术中的价值  

Value of Preoperative Intra-Aortic Balloon Pump in High-Risk Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

作　　者：刘美明[1] 

机构地区：[1]山东省胸科医院心血管外科,济南250013

出　　处：《实用临床医学（江西）》2016年第10期27-30,共4页Practical Clinical Medicine

摘　　要：目的探讨术前预防性应用主动脉球囊反搏在高危冠心病患者非体外循环冠状动脉搭桥术中的意义。方法将32例高危冠心病行非体外循环冠状动脉搭桥术患者按术前是否预防性应用主动脉球囊反搏分为2组:A组12例患者于术前预防性应用主动脉球囊反搏,B组20例患者术前未使用主动脉球囊反搏。比较2组搭桥数,球囊反搏辅助时间,术中转体外循环率,术后低心排发生率、呼吸机辅助时间、血小板减少发生率及死亡率等。结果A组无中转体外循环手术,无围术期死亡;B组术中转体外循环手术8例,术中或术后实施主动脉球囊反搏11例,死亡4例。A组中转体外循环率、球囊反搏时间、术后低心排发生率及呼吸机辅助时间均较B组显著减少(P<0.05)。结论高危冠心病行非体外循环冠状动脉搭桥术,术前预防性应用主动脉球囊反搏可显著改善患者预后。Objective To evaluate the significance of prophylactic preoperative intra-aortic bal-loon pump（IABP）support in high-risk patients undergoing off-pump coronary artery bypass graft （CABG）surgery.Methods Thirty-two high-risk patients with coronary heart disease underwent prophylactic preoperative IABP support（group A,n=12）or not（group B,n=20）.The number of bypass grafts,duration of balloon counterpulsation and mechanical ventilation,ratio of intraopera-tive conversion to on-pump CABG,incidence of postoperative low cardiac output syndrome and thrombocytopenia,and mortality were compared between the two groups.Results In group A,no patients were converted to on-pump CABG and died.In group B,8 patients were converted to on-pump CABG,11 patients underwent intraoperative or postoperative aortic balloon counterpulsati-on,and 4 patients died.Compared with group B,the ratio of intraoperative conversion to on-pump CABG,duration of balloon counterpulsation and mechanical ventilation,and incidence of postoper-ative low cardiac output syndrome significantly decreased in group A（P 〈 0.05）.Conclusion Prophylactic preoperative IABP support can improve prognosis in high-risk patients undergoing CABG surgery.

关 键 词：非体外循环冠状动脉搭桥术 主动脉球囊反搏 术前应用 高危冠心病 

分 类 号：R654[医药卫生—外科学]