不同时机IABP置入在PCI术治疗ACS伴严重心衰中的应用效果观察  

Observation on the Effect of Different Time IABP Placement in PCI for ACS with Severe Heart Failure

作　　者：王东方 王鲜花 王欢 Wang Dongfang;Wang Xianhua;Wang Huan(Chinese Medicine Hospital of Lankao County,Lankao 475300,China)

机构地区：[1]兰考县中医院心内科,河南兰考475300

出　　处：《哈尔滨医药》2019年第5期403-405,共3页Harbin Medical Journal

摘　　要：目的探究不同时机置入主动脉内球囊反搏术(IABP)在经皮冠状动脉介入(PCI)术治疗急性冠状动脉综合征(ACS)伴严重心衰中的应用效果。方法选择2015年1月至2017年1月在我院行PCI术的ACS伴严重心衰患者120例,根据IABP置入时机不同分为术前组(n=40)、术中组(n=40)和术后组(n=40)。比较三组的术后恢复时间和住院时间、术后冠脉造影(TIMI)血流情况、术后一周心功能情况及随访半年主要心脑血管事件(MACCE)发生率。结果术前组的机械通气时间、ICU停留时间、术后IABP支持时间和住院时间明显少于术中组和术后组(P<0.05);手术后三组TIMI血流分级均优于手术前,且术前组优于术中组与术后组(P<0.05);手术后三组的NT-proBNP、LVEF值均优于手术前,且术前组的NT-proBNP值较术中组和术后组低(P<0.05),LVEF值较术中组和术后组高(P<0.05);三组半年内MACCE事件发生率差异无统计学意义(P>0.05)。结论 PCI术前置入IABP治疗ACS伴心衰患者的临床效果优于术中组、术后置入组,临床上满足IABP术前置入指征后应及时置入。Objective To investigate the effect of different time intra-aortic balloon counterpulsation(IABP)in the treatment of acute coronary syndrome(ACS)with severe heart failure with percutaneous coronary intervention(PCI).Methods A total of 120 patients with severe heart failure who underwent PCI in our hospital from January 2015 to January 2017 were enrolled.The patients were divided into preoperative group(n=40),intraoperative group(n=40)and postoperative group(n=40)according to the timing of IABP placement.The postoperative recovery time and hospital stay,postoperative coronary angiography(TIMI)blood flow,cardiac function after one week,and the incidence of MACCE during the follow-up period of half a year were compared between the three groups.Results The mechanical ventilation time,ICU stay time,postoperative IABP support time and hospital stay were significantly less in the preoperative group than those in the intraoperative and postoperative groups(P<0.05).The TIMI blood flow gradings of the three groups were better than those before the operation,and the preoperative group was superior to the intraoperative group and the postoperative group(P<0.05).The NT-proBNP and LVEF values of the three groups were better than those before surgery,and the NT-proBNP value of the preoperative group was lower than that of the intraoperative group and the postoperative group(P <0.05).The LVEF value was higher than that in the intraoperative group and postoperative group(P<0.05).There was no significant difference in the incidence of MACCE events among the three groups within six months(P>0.05).Conclusion The clinical effect of IABP in the treatment of patients with ACS with heart failure before PCI is better than that in the intraoperative group and the postoperative group.It should be placed in time after the IABP preoperative indication.

关 键 词：经皮冠状动脉介入治疗 主动脉球囊反搏术 时机 急性冠状动脉综合征 

分 类 号：R541.6[医药卫生—心血管疾病]