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|本期目录/Table of Contents|

主动脉内球囊反搏技术救治高危冠状动脉旁路移植术患者(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第1期
页码:
79-81
栏目:
临床研究
出版日期:
2007-01-01

文章信息/Info

Title:
Role of intraaortic balloon pump in management of highrisk intraaortic balloon pump patients during perioperative period
作者:
崔勤; 赵荣;  郑霄; 金振晓; 郑奇军; 张胜利; 刘金成; 易定华
第四军医大学西京医院心血管外科中心，陕西 西安 710032
Author(s):
CUI Qin;  ZHAO Rong;  ZHENG Xiao;  JIN Zhenxiao;  ZHENG Qijun;  ZHANG Shengli;  LIU Jincheng;  YI Dinghua
Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi′an 710033, Shaanxi,China
关键词:
主动脉内球囊反搏; 冠状动脉旁路移植术
Keywords:
intraaortic balloon pump;  coronary artery bypass
分类号:
R332.3; R654.2
DOI:
-
文献标识码:
A
摘要:
目的 探讨围手术期应用主动脉内球囊反搏(intraaortic balloon pump，IABP)对高危冠心病患者冠状动脉旁路移植术(coronary artery bypass graft,CABG)患者救治的效果。方法 回顾性分析IABP对42例CABG围手术期患者的临床反应、血流动力学以及病死率的影响。结果 平均IABP辅助时间(87±16)h，辅助期间平均动脉压(MAP)明显升高，心率降低、心排血量指数增加，术中及术前使用可改善心脏不停跳冠状动脉旁路移植术过程中,心脏对稳定器压迫的耐受性，同时使心脏功能差的患者顺利脱离体外循环。34例康复出院，住院死亡8例，主要死亡原因为低心排血量综合征、多器官功能衰竭等。结论 IABP是一种简单有效的循环辅助手段，心功能差的高危CABG患者应积极地放置IABP。
Abstract:
AIM To investigate the role of intraaortic balloon pump (IABP) in the management of highrisk coronary artery byeass graft(CABG) patients during perioperative period. METHODS Fortytwo highrisk coronary artery disease patients with IABP support during CABG procedure were included in this study. Their clinical manifestation, homodynamic data and death rate were retrospectively analyzed. RESULTS The mean time of IABP support was (87±15)h. With IABP support, the mean artery pressure and cardiac index significantly increased and the heart rate slowed down. IABP, set up before or during the operation, could improve the tolerance of the heart to the holder oppression during off pump coronary artery bypass and made the patients much easier to wean from the cardiopulmonary bypass. Thirtyfour patients were discharged rehabilitatively. Eight patients succumbed to low cardiac output symptom or multiple organ failure and died. CONCLUSION IABP is a simple and effective circulation assistance device and its use should be encouraged in the management of highrisk CABG patients.

参考文献/References

［1］Buffolo E, de Andrade CS, Branco JN, et al. Coronary artery bypass grafting without cardiopulmonary bypass ［J］. Ann Thorac Surg,1996,61（1）:63-66.

［2］Christensom JT, Schmuziger M, Simonet F. Effective surgical management of high risk coronary patients using preoperative intraaortic balloon pump counterpulsation therapy ［J］. Cardiovasc Surg,2001,9 (4): 383-390.

［3］Christenson JT, Simonet F, Badel P, et al. Evaluation of preoperative intraaortic balloon pump support in high risk coronary patients ［J］. Eur J Cardiothorac surg,1997,11(6): 1097-1103.

［4］Christenson JT, Simonet F, Badel P, et al. Option timing of preoperative intraaortic balloon pump support in high risk coronary patients ［J］. Ann thorac surg, 1999, 68 (3): 934-939.

［5］Fasseas P,Cohen M,Kopistansky C, et al. Preoperative intraaortic balloon counterpulsation in stable patients with left main coronary disease ［J］. J Invasive Cardiol, 2001, 13 (10): 679-683.

［6］Christenson JT， Schmuziger M， Simonet F. Effective surgical management of highrisk coronary patients using preoperative intraaortic balloon counterpulsation therapy ［J］. Cardiovasc Surg, 2001,9 (4): 383-390.

［7］Kim KB， Lim C，Ahn H, et al. Intraaortic balloon pump therapy facilitates posterior vessel offpump coronary artery bypass grafting in highrisk patients ［J］. Ann Thorac Surg, 2001, 71(6): 1964-1968.

［8］Hausmann H, Potapov EV, Koster A. Prognosis after the implantation of an intraaortic balloon pump in cardiac surgery calculated with a new score ［J］. Circulation, 2002, 106 (12 Suppl 1): I203-I206.

备注/Memo

备注/Memo:
收稿日期：2005-11-03.作者简介：崔勤，副主任医师，副教授 Email：cuiqin@fmmu.edu.cn
更新日期/Last Update: