主动脉内球囊反搏在急性心肌梗死合并心源性休克治疗中的应用The role of intra-aortic ballon counterpulsation in acute myocardial infarction with cardiogenic shock
王嵬民,伍海安,梁明,金哲秀,陈国俊
摘要(Abstract)：
目的评价主动脉球囊反搏术(IABP)在急性心肌梗死(AMI)合并心源性休克治疗中的应用价值。方法选取AMI合并心源性休克患者65例,其中IABP组30例,在IABP支持下行急诊经皮冠状动脉介入治疗(PCI),对照组35例,单纯行急诊PCI治疗。结果IABP组患者在IABP支持下,30 min后血流动力学指标改善,2~8 h血流动力学稳定,均完成梗死相关血管再通,没有血管再闭塞事件发生,无术中死亡,院内死亡率40%;对照组患者院内死亡率74.3%,其中6例在术中死亡。结论IABP可明显改善AMI合并心源性休克患者的血流动力学指标,增加冠状动脉的灌注;IABP可提高急诊PCI的成功率,减少术后低心排综合征及血管再闭塞事件的发生,降低院内死亡率,明显改善了AMI合并心源性休克患者的预后。
关键词(KeyWords)： 主动脉内球囊反搏;心肌梗死;血管成形术,经腔,经皮冠状动脉
基金项目(Foundation):
作者(Author): 王嵬民,伍海安,梁明,金哲秀,陈国俊
参考文献(References)：
- [1]Kantrowitz A,Tjonneland S,Freed PS,et al.Initial clinical experi-ence with intra-aortic balloon pumping in cardiogenic shock.JAMA,1968,203:135-138.
- [2]Fann JI,Sarris CE,Mitchell RS,et al.Treatment of patients withaortic dissection presenting with peripheral vascular complications.AmSurg,1990,212:705-713.
- [3]Umana J,Mtcbell RS.Endovascular treatment of aortic dissectionsand thortic aneurysms.Se minars in vascular surgery,2000,13:290-298.
- [4]Oluman EM,Califf RM,George BS,et al.The thrombolysis and an-gioplasty in myocardial infarction(TAMI)study Group.The use of in-traaortic balloon counterpulsation as an adjunct to reperfusion therapyin acute myocardial infarction.Am Heart J,1991,121:895-901.