主动脉内球囊反搏不同应用时机的疗效研究  

Study on the effect of different application timing of intra-aortic balloon pump

作　　者：蔡庆慧 郭长英[1] 陈红卫[2] 陈英[1] CAI Qinghui;GUO Changying;CHEN Hongwei;CHEN Ying(Cardiac Surgical lntensive Care Unit,Zhengzhou Seventh People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院CSICU,450000 [2]郑州市第七人民医院心外科,450000

出　　处：《心肺血管病杂志》2021年第6期592-596,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨主动脉内球囊反搏(IABP)不同应用时机对冠状动脉旁路移植术(CABG)患者血流动力学、术后恢复、NLR、BNP、并发症的影响。方法:选取我院96例CABG患者,根据IABP放置时机分组,20例患者术前放置,作为A组,46例患者术中放置,作为B组,30例患者术后放置,作为C组。结果:A组体外循环率低于B、C组,IABP使用时间、机械通气时间、ICU滞留时间、住院花费均少于B、C组(P<0.05);A组IABP后2 h心率、中心静脉压均低于B、C组,末梢血氧饱和度均高于B、C组(P<0.05);A组IABP后即刻、IABP后24 h、48 h、72 h、7 d NLR、BNP水平均低于B、C组(P<0.05);A组术后低心排血量综合征(LCOS)、急性肾损伤AKI、新发心房颤动发生率低于C组(P<0.05)。结论:CABG患者的IABP放置时机选在术前无需进行体外循环,临床效果更佳。Objective:To explore the effects of different application timing of intra-aortic balloon pump(IABP)on hemodynamics,postoperative recovery,NLR,BNP,and complications in patients undergoing coronary artery bypass grafting(CABG).Methods:96 CABG patients in our hospital were selected and grouped according to the timing of IABP placement.20 patients were placed before operation,as group A,46 patients were placed during operation,as group B,and 30 patients were placed after operation,as group C.Results:The rate of cardiopulmonary bypass in group A was lower than that in groups B and C.The use time of IABP,mechanical ventilation time,ICU retention time,and hospitalization expenditure were all lower than those in groups B and C(P<0.05).The heart rate and central venous pressure of group A were lower than those of group B and C at 2 h after IABP,and the oxygen saturation of peripheral blood was higher than that of group B and C(P<0.05).The levels of NLR and BNP immediately after IABP,24 h,48 h,72 h,7 d after IABP in group A were lower than those in groups B and C(P<0.05).The incidence of postoperative LCOS,AKI,and new-onset atrial fibrillation in group A was lower than that in group C(P<0.05).Conclusions:The timing of IABP placement for CABG patients is to be selected before surgery without extracorporeal circulation,and the clinical effect is better.

关 键 词：冠状动脉旁路移植术 主动脉内球囊反搏 血流动力学 B型脑钠肽 中性粒细胞与淋巴细胞比值 

分 类 号：R54[医药卫生—心血管疾病]