缺血性心肌病OPCAB治疗患者中辅助应用主动脉内球囊反搏治疗的价值及安全性分析  

Value and safety of intra aortic balloon counterpulsation in patients with ischemic cardiomyopathy treated with OPCAB

作　　者：谭晓荣 宋庆宝 党瑜华[2] Tan Xiao-rong;Song Qing-bao;Dang Yu-hua(Department of Cardiology,Linying People's Hospital,Luohe 462600,Henan,China;Department of Cardiovascular Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]河南省临颍县人民医院心内科,河南漯河462600 [2]郑州大学第一附属医院心血管内科,河南郑州450052

出　　处：《四川生理科学杂志》2022年第1期20-22,26,共4页Sichuan Journal of Physiological Sciences

基　　金：河南省科技攻关计划项目(编号:SB202001238)。

摘　　要：目的:分析缺血性心肌病非体外循环冠状动脉旁路移植术(Off pump coronary artery bypass grafting,OPCAB)治疗中辅助应用主动脉内球囊反搏(Intra aortic balloon counterpulsation,IABP)治疗的价值及安全性。方法:于我院(2018年9月至2020年9月)收治的缺血性心肌病患者中,抽取82例,随机分为对照组、观察组,每组41例,两组均行OPCAB治疗,在此基础上,对照组行常规处理,观察组行IABP治疗,对比两组治疗效果、围术期临床指标、肌酸激酶同工酶(Creatine kinase isoenzyme,CK-MB)及肌钙蛋白(Cardiac troponin I,cTnI)水平、并发症发生率及预后。结果:观察组的治疗效果、各项手术指标、左室舒张末内径均优于对照组(P<0.05);治疗后,两组CK-MB、cTnI水平均降低,且研究组降低得更显著(P<0.05);观察组并发症发生率低于对照组(P<0.05);术后持续对患者随访半年,两组心功能均明显改善(P<0.05),术后1个月、半年内观察组复发率低于对照组,但差异无统计学意义(P>0.05)。结论:缺血性心肌病OPCAB治疗中应用IABP效果显著,安全性高。Objective:To analyze the value and safety of intra aortic balloon counterpulsation(IABP)in patients with ischemic cardiomyopathy treated with off pump coronary artery bypass grafting(OPCAB).Methods:82 patients with ischemic cardiomyopathy treated in our hospital(September 2018 to September 2020)were selected and divided into control group and observation group randomly,41 cases in each group.Both groups were treated with OPCAB.On this basis,the control group was treated with routine treatment and the observation group was treated with IABP.The treatment effects,perioperative clinical indexes,the levels of creatine kinase isoenzyme(CK-MB)and cardiac troponin I(cTnI),the incidence of complications and prognosis of the two groups were compared.Results:The therapeutic effect,surgical indexes and left ventricular end diastolic diameter in the observation group were better than those in the control group(P<0.05);After treatment,the levels of CK-MB and cTnI decreased in both groups,and they decreased more significantly in the study group(P<0.05);The incidence of complications in the observation group was lower than that in the control group(P<0.05);After continuous follow-up for half a year,the cardiac function of the two groups were significantly improved(P<0.05).The recurrence rate of the two groups were similar.Conclusion:IABP is effective and safe in OPCAB treatment of ischemic cardiomyopathy.

关 键 词：缺血性心肌病 主动脉内球囊反搏 非体外循环 冠状动脉 旁路移植术 

分 类 号：R54[医药卫生—心血管疾病]