主动脉内球囊反搏在小儿的应用进展  

Advances in the application of intraaortic balloon pumping in children

作　　者：魏丹[1] 任晓旭[2] Wei Dan;Ren Xiaoxu(Department of Cardiac Surgery, Children′s Hospital Attached to the Capital Institute of Pediatrics, Beijing 100020, China)

机构地区：[1]首都儿科研究所附属儿童医院心脏外科监护室,北京100020 [2]首都儿科研究所附属儿童医院重症监护室,北京100020

出　　处：《中国小儿急救医学》2018年第6期419-423,共5页Chinese Pediatric Emergency Medicine

摘　　要：主动脉内球囊反搏（intraaortic balloon pump，IABP）是短期循环机械辅助装置之一。该技术可以增加冠状动脉血流量以提高心肌的供血供氧并减轻心肌氧耗、降低心脏后负荷来改善心脏功能，从而增加心输出量。该技术最早于1967年在成人应用，至1980年Pollock医生首次在小儿应用了IABP并取得成功。之后陆续有儿科患者应用IABP的报道，大部分为先天性心脏病术后出现低心排出量综合征的患儿，少数为心肌病、心肌炎、等待心脏移植的患儿，生存率25%～100%。对于处在心脏术后不能撤离体外循环、等待使用心室辅助或体外膜肺氧合、等待心脏移植的过渡阶段，发生左心衰竭导致低心排的患儿，IABP可以作为一项心脏辅助技术，提高心排血量，降低病死率，但是随着心室辅助装置和体外膜肺氧合技术不断成熟，IABP是否是早期心脏辅助的最佳选择有待进一步对比研究。Intraaortic balloon pump （IABP） is one of the short-term circulatory mechanical support technique.This technique can increase the blood flow of the coronary arteries to improve the blood and oxygen supply to myocardium, reduce the cardiac afterload, increase cardiac output.This technique was first used on adult in 1967 and till 1980 doctor Pollock used it on children successfully.After that there were several reports of pediatric patients using IABP, most of them are patients with congenital heart disease who had low cardiac output syndrome postoperatively, others were cardiomyopathy, myocarditis and children waiting for a heart transplant, total survival rate was 25%-100%.For children who can′t wean from cardiopulmonary bypass, bridge to the use of ventricular assist or extracorporeal membrane oxygenation and heart transplant, left ventricle failure leads to low cardiac output, IABP can be used to improve cardiac output and reduce mortality.However, with maturing of extracorporeal membrane oxygenation and ventricular assist device, whether IABP is the best choice for early cardiac assistance needs to be further studied.

关 键 词：主动脉内球囊反搏 小儿 低心排出量综合征 心力衰竭 

分 类 号：R720.597[医药卫生—急诊医学]