预防性置入主动脉内球囊反搏应用于高危冠心病行冠状动脉旁路移植术患者的临床疗效分析  

Analysis of clinical efficacy of preventive applying intra-aortic balloon pump in high-risk coronary heart disease patients undergoing coronary artery bypass grafting

作　　者：郑道阔 葛振伟[2] 朱喜亮 程兆云[2] 马露 张华坤 张桥 李传威 刘前进 赵勇 ZHENG Dao-kuo;GE Zhen-wei;ZHU Xi-liang;CHENG Zhao-yun;MA Lu;ZHANG Hua-kun;ZHANG Qiao;LI Chuan-wei;LIU Qian-jin;ZHAO Yong(Department of Cardiovascular Surgery,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Cardiovascular Surgeiy,Heart Center of Henan Provincial People's Hospital,Cental China Fuwai Hospital,Zhengzhou 451464,China)

机构地区：[1]河南大学人民医院,河南省人民医院心血管外科,河南省郑州市450003 [2]河南省人民医院心脏中心,华中阜外医院心血管外科

出　　处：《中国心血管病研究》2021年第3期231-235,共5页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金(31970766)。

摘　　要：目的探讨预防性置入主动脉内球囊反搏(intra-aortic balloon pump,IABP)在高危冠心病患者接受冠状动脉旁路移植术(coronary artery bypass graft,CABG)中的临床疗效。方法回顾并总结我院2013年1月至2020年6月175例CABG围术期行IABP置入术患者的临床资料,术前平均年龄(61.2±9.2)岁,其中男性131例(74.9%)。根据IABP置入时机分为预防性置入组(术前置入IABP)(66例)和对照组(术中或术后置入IABP)(109例),对比分析两组患者临床资料。结果两组患者一般基线资料差异无统计学意义(P>0.05)。与对照组相比,预防性置入组IABP支持时间[(107.5±68.3)h比(130.4±72.6)h],机械通气时间[(76.9±82.1)h比(129.6±160.5)h],ICU监护时间[(145.9±99.9)h比(196.4±180.5)h]显著减少(P<0.05)。术后急性肾损伤(13.6%比28.4%)、低心排量综合征(0比6.4%)、多器官功能衰竭(0比7.3%)发生率降低,差异有统计学意义(P<0.05)。预防性置入组围术期病死率(10.6%)低于对照组(22.9%),差异有统计学意义(P<0.05)。结论对于接受CABG治疗的高危冠心病患者,术前预防性置入IABP可降低患者围术期病死率,降低术后急性肾损伤、低心排量综合征、多器官功能衰竭发生率,缩短IABP支持时间、机械通气时间和ICU监护时间。Objective To investigate the clinical efficacy of preventive applying intra-aortic balloon pump(IABP)in patients with high-risk coronary heart disease undergoing coronary artery bypass graft(CABG).Methods From January 2013 to June 2020,the clinical data of the 175 cases were reviewed.The average age was(61.2±9.2)years,including 131 males(74.9%).According to the timing of IABP applying,they were divided into prophylactic group(prophylactic of IABP)(n=66)and control group(intraoperative or postoperative placement of IABP)(n=109).The perioperative data of the two groups were compared and analyzed.Results There was no significant difference in baseline information between two groups of patients(P>0.05).Compared with the control group,IABP support time[(107.5±68.3)h vs.(130.4±72.6)h],intubation time[(76.9±82.1)h vs.(129.6±160.5)h]and intensive care unit(ICU)stay time[(145.9±99.9)h vs.(196.4±180.5)h]significantly reduced(P<0.05)and the incidence of postoperative acute kidney injury(13.6%vs.28.4%),low cardiac output syndrome(0 vs.6.4%)and multiple organ failure(0 vs.7.3%)decreased in the preventive group significantly(P<0.05).The perioperative mortality of the prophylactic group(10.6%)was significantly lower than that of the control group(22.9%)(P<0.05).Conclusion To carry out CABG for patients with high-risk coronary heart disease,preoperatively preventive applying IABP can reduce the perioperative mortality,the incidence of postoperative acute kidney injury,low cardiac output syndrome and multiple organ failure and shorten IABP time,intubation time and ICU stay time.

关 键 词：主动脉球囊反搏 冠状动脉旁路移植术 冠状动脉疾病 

分 类 号：R654.2[医药卫生—外科学]