主动脉内球囊反搏在冠状动脉搭桥术后低心排血量治疗中的应用  

Application of intra-aortic balloon pump in the treatment of low cardiac output after coronary artery bypass grafting

作　　者：张满堂[1] 吴小永[1] 杜敏 王茜 Zhang Mantang;Wu Xiaoyong;Du Min;Wang Qian(Department of Cardio-Thoracic Surgery,Jiaozuo People’s Hospital,Jiaozuo 454000,China;Department of Critical Medicine,Jiaozuo People’s Hospital,Jiaozuo 454000,China)

机构地区：[1]焦作市人民医院心胸外科,焦作454000 [2]焦作市人民医院重症医学科,焦作454000

出　　处：《中国实用医刊》2022年第18期67-70,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨主动脉内球囊反搏(IABP)治疗冠状动脉搭桥术后低心排血量的效果。方法抽取2020年1月至2022年1月焦作市人民医院收治的冠状动脉搭桥术后出现低心排血量的患者60例。根据治疗方案将其分为两组:采用IABP治疗的30例患者作为观察组,采用常规药物治疗的30例患者作为对照组。比较两组治疗前后血流动力学指标以及不良事件发生情况。结果治疗前,两组心率、平均动脉压、心排指数、每搏输出量、尿量、中心静脉压及心脏舒张期动脉压比较,差异未见统计学意义(P>0.05);治疗后,观察组平均动脉压、心排指数、每搏输出量、尿量及心脏舒张期动脉压均高于对照组,而心率、中心静脉压则低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(6.67%,2/30)低于对照组(26.67%,8/30),观察组心脏功能好转时间[(4.63±1.82)d]短于对照组[(6.12±1.65)d],P<0.05。结论与常规药物方案相比,IABP治疗冠状动脉搭桥术后低心排血量患者不仅能更好地改善其血流动力学指标,缩短心脏好转时间,降低并发症发生率。Objective To investigate the application effect of intra-aortic balloon pump(IABP)in the treatment of patients with low cardiac output after coronary artery bypass grafting.Methods A total of 60 patients with low cardiac output after coronary artery bypass grafting who were admitted to Jiaozuo People’s Hospital from January 2020 to January 2022 were selected for the study.They were divided into two groups according to treatment schemes,30 patients treated by IABP as the observation group and 30 patients treated with conventional drugs as the control group.The preoperative and postoperative hemodynamic indexes,and occurrence of adverse events were compared the two groups.Results Before treatment,there was no significant difference in heart rate,mean arterial pressure,cardiac output index,stroke volume,urine volume,central venous pressure and diastolic arterial pressure between the two groups(P>0.05);after treatment,the mean arterial pressure,cardiac output index,stroke volume,urine volume and diastolic arterial pressure in the observation group were higher than those in the control group,while the heart rate and central venous pressure were lower than those in the control group(P<0.05).The complication rate of the observation group(6.67%,2/30)was lower than that of the control group(26.67%,8/30),and the improvement time of cardiac function in the observation group was(4.63±1.82)d,shorter than(6.12±1.65)d in the control group(P<0.05).Conclusions Compared with the conventional drug regimen,IABP in the treatment of patients with low cardiac output after coronary artery bypass grafting can better improve their hemodynamic indicators,shorten the time of cardiac improvement,and reduce the incidence of complications.

关 键 词：冠状动脉搭桥术 低心排血量 主动脉内球囊反搏 血流动力学指标 

分 类 号：R654.2[医药卫生—外科学]