主动脉内球囊反搏植入患者并发症及预后的回顾性分析  

Retrospective analysis of complications and prognosis in patients implanted with intra-aortic balloon pump

作　　者：易东 鄢华[1] 徐承义[1] 刘成伟[1] Yi Dong;Yan Hua;Xu Chengyi;Liu Chengwei(Department of Cardiology,Wuhan Asia Heart Hospital,Wuhan 430000,China)

机构地区：[1]武汉亚洲心脏病医院心血管内科,430022

出　　处：《心脑血管病防治》2023年第12期1-4,15,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：武汉市卫生计生科研基金(WX18Q08)。

摘　　要：目的分析心血管疾病危重患者植入主动脉内球囊反搏(IABP)的并发症发生率及预后。方法回顾性分析2016年1月至2021年7月武汉亚洲心脏病医院因心血管疾病植入IABP患者的临床资料,分析IABP植入患者并发症发生率及院内死亡或放弃治疗比例。结果共纳入1195例IABP植入患者,平均年龄(65.9±11.7)岁,其中男性815例(68.2%),急性冠状动脉综合征1115例(93.3%),少数患者为慢性冠状动脉综合征、慢性心力衰竭和病毒性心肌炎等。植入指征包括急性心力衰竭396例(33.1%)、顽固性心力衰竭235例(19.7%)、缺血性心绞痛232例(19.4%)、复杂经皮冠状动脉介入围术期154例(12.9%)等。IABP平均使用(141.6±134.6)h,共67例(5.6%)患者出现并发症(26例大出血,12例下肢缺血,10例周围动脉栓塞,3例穿刺部位假性动脉瘤,其他16例包括伤口感染、血小板显著减低和脑梗死)。不同性别、年龄和基础疾病种类的患者并发症发生率差异无统计学意义(P>0.05),不同植入指征并发症发生率差异有统计学意义(χ^(2)=21.046,P<0.01),有并发症患者IABP保留时间长于无并发症患者,差异有统计学意义(t=3.113,P<0.01)。住院期间296例(24.8%)患者死亡或放弃治疗,这部分患者女性比例更高、年龄更大(χ^(2)/t=3.986、3.690,P<0.05),基础疾病种类和植入指征差异有统计学意义(χ^(2)=30.736、119.618,均P<0.01),IABP保留时间更短(t=-3.283,P<0.01),但并发症发生情况及种类差异均无统计学意义(P>0.05)。结论IABP植入患者并发症发生率较低,并发症主要与植入指征及IABP保留时间长短有关。IABP植入患者预后较差,女性、年龄更大及病情严重的患者预后更差。Objective To analyze the incidence and prognosis of complications after intra-aortic balloon pump(IABP)implantation in critically ill patients with cardiovascular disease.Methods Clinical data of IABP implanted patients with cardiovascular diseases in Wuhan Asia Heart Hospital from January 2016 to July 2021 were retrospectively analyzed.Incidence of complications,proportions of in-hospital death or abandoning treatment were analyzed.Results A total of 1195 patients with IABP implantation were included,with an average age of(65.9±11.7)years.Among them,815(68.2%)were males,1115(93.3%)presented with acute coronary syndromes,and a minority had chronic coronary syndromes,chronic heart failure,and viral myocarditis etc.Indications for implantation included acute heart failure(396 cases,33.1%),refractory heart failure(235 cases,19.7%),ischemic angina pectoris(232 cases,19.4%),complex percutaneous coronary intervention(PCI)during perioperative period(154 cases,12.9%).The mean duration of IABP usage was(141.6±134.6)hours,and 67 patients(5.6%)experienced complications(26 cases of massive hemorrhage,12 cases of lower limb ischemia,10 cases of peripheral arterial embolism,3 cases of pseudoaneurysm at the puncture site,16 cases of wound infection,significant platelet reduction,or cerebral infarction).There were no statistically significant differences in the incidences of complications among patients of different genders,ages and underlying disease types(P>0.05),while there was statistically significant difference in the incidence of complications among patients with different implant indications(χ^(2)=21.046,P<0.01).Duration of IABP retention in patients with complications was significantly longer than that in patients without complications(t=3.113,P<0.01).During hospitalization,296 patients(24.8%)died or discontinued treatment.This subset of patients had a higher proportion of females(χ^(2)=3.986,P<0.05)and were older(t=3.960,P<0.01);there were statistically significant differences in the types of underlying disease and

关 键 词：主动脉内球囊反搏 急性心肌梗死 心源性休克 并发症 预后 

分 类 号：R54[医药卫生—心血管疾病]