主动脉内球囊反搏对心脏移植术后围手术期感染的影响  

Effect of Intra⁃Aortic Balloon Pump on infection after heart transplantation during perioperative period

作　　者：刘云霏 郭琳[1] 浮志坤[2] 朱勇锋[2] 梁可可 张向立[2] LIU Yunfei;GUO Lin;FU Zhikun;ZHU Yongfeng;LIANG Keke;ZHANG Xiangli(Department of Intensive Care Unit,Department of Heart Transplant Center,the 7th People′s Hospital of Zhengzhou,Zhengzhou 450016,China;不详)

机构地区：[1]郑州市第七人民医院重症医学科,郑州450016 [2]郑州市第七人民医院心脏移植中心,郑州450016

出　　处：《实用医学杂志》2023年第7期844-848,854,共6页The Journal of Practical Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20191120)。

摘　　要：目的探讨主动脉内球囊反搏对心脏移植术后围手术期感染的影响。方法回顾性分析2018年5月至2021年10月在郑州市第七人民医院接受同种原位心脏移植手术的112例患者的临床资料,根据术前是否使用主动脉内球囊反搏(intra-aortic balloon pump,IABP)作为心脏移植术前过渡治疗分为IABP组(n=43)和非IABP组(n=69),比较两组患者临床资料,分析两组患者感染指标及感染发生率。结果术前两组患者在供受体年龄,受体基础疾病、既往病史、原发病、血液学检查、术中资料上差异无统计学意义(P>0.05),但术前IABP组需血管活性药物维持循环、ECMO及气管插管比例明显高于非IABP组(P<0.05),术前IABP组降钙素原高于非IABP组、淋巴细胞计数低于IABP组(P<0.05),术后IABP组白细胞及中性粒细胞计数高于非IABP组(P<0.05),两组患者术后总感染例数及不同系统的感染发生率差异无统计学意义(P>0.05),两组患者累积生存率差异无统计学意义(P>0.05)。结论将IABP作为心脏移植术前的过渡治疗不会增加术后早期感染发生率及长期生存率。Objective To investigate the effect of intra⁃aortic balloon pump treatment on infection after heart transplantation during perioperative period.Methods Clinical data of 112 patients undergoing heart trans⁃plantation in the 7th People′s Hospital of Zhengzhoufrom May 2018 to October 2021 were retrospectively analyzed.According to whether intra⁃aortic balloon Pump(IABP)treatment as a bridge to heart transplantation,all patients were divided into IABP group(n=43)and non⁃IABP group(n=69).Clinical data were statistically compared between the two groups,and the infection indexes and the incidence of infection in the two groups were analyzed.Results There were no significant differences in general data such as donor age,recipient age,recipient basic diseases,previous diseases,primary diseases,hematological examination and intraoperative data between the two groups(P>0.05),but the proportion of vasoactive drugs to maintain circulation,ECMO and endotracheal intuba⁃tion in IABP group was significantly higher than that in non⁃IABP group(P<0.05),and procalcitonin in IABP group was higher than that in non⁃IABP group.The lymphocyte count was lower than that in IABP group(P<0.05),and the leukocyte and neutrophil counts in IABP group were higher than those in non⁃IABP group.There was no significant difference in postoperative total infection incidence and the infection incidence of different systems between the two groups(P>0.05).Conclusion IABP treatment as a bridge to heart transplantation does not increase the incidence of early postoperative infections and long⁃term survival.

关 键 词：心脏移植 主动脉内球囊反搏 围手术期 术后感染 

分 类 号：R617[医药卫生—外科学] R541[医药卫生—临床医学]