亚低温对AMI伴心源性休克患者术后心排量的影响  

Effect of mild hypothermia on postoperative cardiac output of patients with AMI complicated with cardiac shock

作　　者：陈友权[1] 王世祥[1] 陈晞明[1] 许耘红[1] 何晓青[1] 

机构地区：[1]广州医科大学附属第三医院,广东广州510150

出　　处：《热带医学杂志》2017年第5期662-665,共4页Journal of Tropical Medicine

摘　　要：目的探讨亚低温对急性心肌梗死(AMI)伴心源性休克患者急诊经皮冠状动脉介入治疗(PCI)后心排量的影响。方法按照入院先后顺序将70例AMI伴心源性休克患者分为观察组与对照组,均行急诊PCI术,观察组给予亚低温联合主动脉内球囊反搏术(IABP)支持下急诊PCI治疗,对照组则行IABP支持下急诊PCI治疗,比较两组治疗前后心脏指数(CI)、肌酐(Cr)、血氧饱和度(Sv Q2)、尿量、左室射血分数(LVEF)变化情况,统计记录两组去甲肾上腺素使用剂量、并发症及28 d存活率。结果与治疗前比较,两组治疗后CI、尿量、Sv O2、LVEF均显著增多,Cr显著降低,差异有统计学意义(P<0.05);且观察组治疗后上述指标均明显优于对照组(P<0.05);观察组术后去甲肾上腺素使用剂量明显少于对照组(P<0.05)。两组严重心律失常、心力衰竭、低血压及休克发生率、28 d存活率比较差异均无统计学意义(P>0.05)。结论亚低温联合IABP辅助急诊PCI治疗AMI伴心源性休克患者存活率稍高,并发症少,能明显改善患者术后循环功能及心功能,减少去甲肾上腺素使用剂量。Objective To explore the effect of mild hypothermia on cardiac output of patients with acute myocardial infarction （AMI） complicated with cardiac shock after percutaneous coronary intervention （PCI）. Methods Seventy patients with AMI complicated with cardiac shock were divided into the observation group and the control group according to the order of admission, and all patients underwent emergency PCI. The observation group was treated with mild hypothermia combined with emergency PCI under IABP support, while the control group was treated with emergency PCI under IABP support alone. The changes of cardiac index （CI） , creatinine （Cr） and left ventricular ejection fraction （LVEF） before and after treatment were compared between the two groups. The dose of norepinephrine, complications and 28 d survival rate were recorded. Results After treatment, CI, urine volume, SvO2 and LVEF were significantly increased, while Cr was significantly decreased （P〈0.05） , and the above indexes in the observation group were significantly better than those in control group （P〈0.05） ; After operation, the dose of norepinephrine in the observation group was significantly lower than that in control group （P〈0.05）. There were no significant differences in the incidence rates of severe arrhythmia, heart failure, hypopiesia and shock and 28 d survival rates between the two groups （P〉0.05）. Conclusion Survival rate of patients with AMI complicated with cardiac shock treated by mild hypothermia combined with IABP assisted emergency PCI is high, with few complications. It can significantly improve postoperative circulatory function and cardiac function, and reduce the dose of norepinephrine.

关 键 词：急性心肌梗死 心源性休克 亚低温 心排量 

分 类 号：R542.22[医药卫生—心血管疾病]