ECMO联合IABP治疗高危冠心病的效果及患者预后的影响因素分析  

Analysis of effect of ECMO combined with IABP in the treatment of high-risk coronary heart disease and influencing factors of patients’ prognosis

作　　者：刘锋锋 郑建杰[1] LIU Fengfeng;ZHENG Jianjie(the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710061

出　　处：《临床医学研究与实践》2022年第1期19-22,共4页Clinical Research and Practice

基　　金：重点产业创新链(群)-社会发展领域项目(No.S2021-YF-ZDCXL-ZDLSF-0165)。

摘　　要：目的分析体外膜肺氧合(ECMO)联合主动脉内球囊反搏(IABP)治疗高危冠心病的效果及患者预后的影响因素。方法选取我院收治的80例高危冠心病患者,根据治疗方法的不同将其分为ECMO组(50例,ECMO治疗)和联合组(30例,ECMO联合IABP治疗)。比较ECMO组和联合组的血流动力学指标、ECMO使用时间、院内死亡率及并发症发生情况。根据患者是否发生院内死亡将其分为死亡组和存活组,比较两组的临床资料。使用二元Logistic回归分析影响高危冠心病患者预后的相关因素。结果治疗后,ECMO组和联合组的LVEF、MAP均升高,HR均降低,且联合组明显优于ECMO组(P<0.05)。ECMO组和联合组的ECMO使用时间、院内死亡率、并发症总发生率比较,差异无统计学意义(P>0.05)。死亡组的LVEF明显低于存活组,心源性休克发生率明显高于存活组(P<0.05)。LVEF、心源性休克均与高危冠心病患者的预后明显相关(P<0.05)。结论 ECMO联合IABP辅助治疗高危冠心病可明显改善患者的血流动力学指标,降低院内病死率,且安全性较好。Objective To analyze the effect of extracorporeal membrane oxygenation(ECMO) combined with intra-aortic balloon pump counterpulsation(IABP) in the treatment of high-risk coronary heart disease and the influencing factors of patients’ prognosis.Methods A total of 80 patients with high-risk coronary heart disease admitted in our hospital were selected and divided into ECMO group(50 cases,ECMO treatment) and combined group(30 cases,ECMO combined with IABP treatment) according to the different treatment methods.The hemodynamic indexes,ECMO use time,hospital mortality and complications were compared between the ECMO group and the combined group.According to whether died in hospital,the patients were divided into death group and survival group,and the clinical data of the two groups were compared.Binary Logistic regression was used to analyze the related factors that affect the prognosis of patients with highrisk coronary heart disease.Results After treatment,the LVEF and MAP in the ECMO group and the combined group increased,the HR decreased,and those in the combined group were significantly better than the ECMO group(P<0.05).There were no statistically significant differences in the ECMO use time,hospital mortality and total incidence of complications between the ECMO group and the combined group(P>0.05).The LVEF in the death group was significantly lower than that in the survival group,and the incidence of cardiogenic shock was significantly higher than that in the survival group(P<0.05).LVEF and cardiogenic shock were significantly related to the prognosis of patients with high-risk coronary heart disease(P<0.05).Conclusion ECMO combined with IABP for adjuvant treatment of high-risk coronary heart disease can significantly improve the patients’ hemodynamic indexes,reduce the hospital mortality,and has a good safety.

关 键 词：体外膜肺氧合 主动脉内球囊反搏 高危冠心病 预后 

分 类 号：R541.6[医药卫生—心血管疾病]