预防性应用主动脉球囊反搏在高危左主干病变冠状动脉移植手术中的作用  

Prophylactic intra-aortic balloon pump insertion on patients with high risk left main coronary artery disease during the off-pump coronary artery bypass grafting

作　　者：吕晓[1] 牛兆倬[1] 生伟[1] 乔友进[1] 吴建涛[1] 张文峰 池一凡[1] 

机构地区：[1]青岛市市立医院心脏外科,266071

出　　处：《心肺血管病杂志》2018年第1期42-45,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨在高危左主干狭窄的冠心病患者在接受冠状动脉旁路移植手术(CABG)前,预防性应用主动脉球囊反搏(IABP)的临床效果。方法:回顾性分析我院部分高危左主干狭窄冠心病患者,接受CABG手术的病例,手术均采用不停跳CABG手术,术前安装IABP的共有56例。同时统计在我院接受CABG手术围手术期紧迫情况下安装IABP的病例,共有16例。比较这两组病例术中被迫紧急建立体外循环的比例,IABP反搏时间、气管插管时间、ICU时间及术后住院天数。观察术后1 d、术后2 d血浆肌钙蛋白I(c Tn I)。结果:术中紧迫组被迫紧急建立体外循环比例高于术前应用组;IABP反搏时间、气管插管时间,预防组少于紧迫组;预防组的术后住院天数少于紧迫组。紧迫组术后2d c Tn I高于预防组。结论:在高危左主干病变CABG手术中预防性应用IABP可以改善围术期的管理,提高救治成功率。Objective： Clinical outcomes of patients who received prophylactic intra-aortic balloon pump support with left main coronary artery disease in high risk during off-pump coronary artery bypass grafting（ CABG） were assessed in this study. Methods： we retrospectively reviewed the 56 cases with high risk left main coronary artery diseases,who accepted the prophylactic intra-aortic balloon insertion during off-pump CABG. At the same time we reviewed the clinical outcomes of the 16 cases who accepted the ＂rescue＂IABP insertion during CABG. The rate of conversion to CPB,time of IABP,intubation and ICU stay length,postoperative hospital days were compared. Plasma levels of cardiac Troponin I（ c Tn I） were measured perioperatively.Results： The prophylactic group had lower rate of conversion to CPB and less time of IABP,less time of incubation and postoperative hospital days. The prophylactic group also had lower c Tn I values compared to the rescue group. Conclusion： Evidence suggests that prophylactic use of IABP may improve the peri-operative management of high risk patients undergoing CABG.

关 键 词：预防性 主动脉内球囊反搏 冠状动脉旁路移植术 体外循环 

分 类 号：R54[医药卫生—心血管疾病]