容量减少结合频率降低方法在主动脉内球囊反搏撤机中的应用  

Progressive volume deflation followed by rate reduction in weaning intra-aortic balloon pump

作　　者：刘浩[1] 何毅[1] 杨琦[1] 江雪艳[1] 汤敏[1] 梅举[1] 

机构地区：[1]上海交通大学医学院附属新华医院心胸外科,上海200082

出　　处：《中国胸心血管外科临床杂志》2018年第3期188-192,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：上海交通大学医学院科研项目(13XJ10022)

摘　　要：目的研究容量减少结合频率降低方法在主动脉内球囊反搏(IABP)撤机时患者血流动力学变化的改变,探索更为优良的撤机方法。方法 2006年9月至2016年1月,上海交通大学医学院附属新华医院心胸外科共采用容量减少结合频率降低方法完成低心排血量综合征患者IABP撤机36例,年龄(68.9±4.7)岁,男22例、女14例。所有患者均采用全身麻醉及Seldinger法行股动脉穿刺术置入IABP导管,采用容量减少结合频率降低法撤除IABP辅助,并于各时间点采集血流动力学参数。结果全组患者均顺利撤除IABP,1例患者在成功撤机后36 h后再次IABP辅助循环,院内死亡1例。术后出现IABP相关并发症3例(8%),均为足趾动脉栓塞,其中IABP置入同侧肢体栓塞1例,对侧肢体栓塞2例;合并急性肝功能不全1例,急性肾功能不全1例,均经治疗后痊愈。结论使用容量减少结合频率降低方法进行IABP撤机,患者血流动力学稳定,撤机顺利。Objective To investigate the changes of hemodynamics in patients weaning intra-aortic balloon pump （IABP） by using progressive volume deflation followed by rate reduction. Methods We retrospectively analyzed the clinical data of 36 patients aged 68.94-4.7 years, 22 males and 14 females, who underwent progressive volume deflation followed by rate reduction for IABP weaning in Xinhua Hospital between September 2006 and January 2016. Progressive volume deflation followed by rate reduction was used to wean IABP and collect hemodynamics parameters of each time point. Results All the patients successfully weaned IABP. One patient got re-IABP assistant 36 hours after the first successful weaning. One early death and three patients （8%） with postoperative IABP-related complications were embolization of the toe artery. One was in ipsilateral limb, and two of contralateral limb. One patient with acute hepatic insufficiency and one patient with acute renal insufficiency cured after treatment. Conclusion Intra-aortic balloon pump weaning is successful by using volume deflation followed by rate reduction which allowed better hemodynamic parameters.

关 键 词：主动脉内球囊反搏 撤机 容量减少 频率降低 低心排血量综合征 

分 类 号：R654.2[医药卫生—外科学]