主动脉内球囊反搏在冠脉搭桥手术围手术期应用时机与疗效的探讨
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2011年第1期
- 页码:
- 107-109
- 栏目:
- 临床研究
- 出版日期:
- 2010-10-27
文章信息/Info
- Title:
- Timing and effectiveness of perioperative intraaortic balloon pump in coronary artery bypass graft patients
- Author(s):
- ZHOU Wei; XIN Jun; LU Jun; DU Wei; ZHOU Jian-ping; LI Wei-yang
- Department of Thoracardiac Surgery, Dongguan People’s Hospital, Dongguan 523018, Guangdong, China
- 分类号:
- R541.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的: 探讨主动脉内球囊反搏（IABP）在重症冠心病患者围手术期的应用时机。方法： 回顾分析2003年1月～2009年8月45例重症冠心病患者在围手术期应用IABP 的临床资料。根据使用时机不同分为3组：术前组13例，术中组13例，术后组19例,对各组术后呼吸机辅助时间，血管活性药物使用时间，ICU监护时间，术后IABP支持时间，平均心脏指数及手术死亡率等指标进行对比。结果： 45例患者均完成冠脉搭桥手术，总手术死亡率为31%，术前组在术后72 h心脏指数明显优于术中组和术后组，呼吸机辅助时间，术后IABP支持时间明显短于术中组和术后组，手术死亡率低于术后组(均P<0.05)， 术前组患者术后使用血管活性药物时间较术中组和术后组缩短(P<0.05)。 结论： IABP是救治重症高危冠心病患者的安全有效手段，对高危患者术前积极应用IABP辅助治疗，可改善心脏功能，增加手术安全性，降低围手术期死亡率。
- Abstract:
- AIM: To retrospectively investigate the timing and effectiveness of perioperative intraaortic balloon pump (IABP) in coronary artery bypass graft (CABG) patients. METHODS: Forty-five patients treated with IABP for severe coronary heart disease (CHD) from January 2003 to August 2009 were divided into three groups according to the time of IABP: preoperative group (n=13), intraoperative group (n=13) and postoperative group (n=19). Perioperative mortality, inotropic drug consumed time, postoperative cardiac index at 72 h, IABP support time, ventilation assist time and intensive care unit (ICU) stay time were analyzed and compared between the three groups. RESULTS: All 45 patients received CABG and total mortality was 31%. In the preoperative group, the postoperative cardiac index at 72 h was better than in both intra- and postoperative groups, whereas the IABP support time, ventilation assist time, length of stay in intensive care unit (ICU), time of intropic drug use and perioperative mortality were much lower than in intra- or postoperative group. CONCLUSION: IABP is a safe and effective mode for circulation support. For severe CHD patients, preoperative IABP is strongly recommended because it improves cardiac function, offers enhanced surgical safety and significantly decreases perioperative mortality.
参考文献/References
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[9]张南滨，汪曾炜，王辉山,等.重症冠状动脉旁路移植手术围手术期IABP的临床应用[J].心肺血管病杂志， 2006, 25(4):242-243.
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备注/Memo
- 备注/Memo:
- 收稿日期：2010-03-01.作者简介：周伟，主治医师，硕士Email:zhouwei78627163@163.com
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