主动脉内球囊反搏术在急性心肌梗死合并心源性休克患者冠状动脉介入术中的疗效评估Therapeutic efficacy of intra-aortic balloon pump support in patients with acute myocardial infarction complicated by cardiogenic shock undergoing percutaneous coronary intervention
顾俊,胡伟,肖红兵,冯小弟,余强,金贤,尹桂芝,陈诚军,陈跃光,张大东
摘要(Abstract):
目的评价急性心肌梗死合并心源性休克患者行急诊介入治疗时常规主动脉内球囊反搏术(IABP)的可行性及有效性。方法41例在IABP支持下行急诊介入治疗的合并心源性休克的急性心肌梗死患者为治疗组,将同期行急诊介入治疗但没有行IABP支持的合并心源性休克的急性心肌梗死患者47例设为对照组;比较两组术后2周、3个月的左室功能,评价2组术后30天以及3个月的MACE事件发生率。结果IABP组患者术后2周、3个月的左室功能较对照组明显改善(43.8%±8.2%比39.4%±5.9%,45.5%±6.6%比40.6%±4.6%,P均<0.05);两组患者术后30天(16/41比30/47)、3个月(18/41比33/47)的MACE事件差异也有统计学意义(P均<0.05),其中IABP组在降低术后30天、3个月的死亡率方面尤为明显(30天16/41比对照组30/47,3个月18/41比对照组33/47,P均<0.05)。结论对合并心源性休克的急性心肌梗死患者行急诊PCI同时采用IABP支持治疗能有效改善左室功能和减少主要心血管不良事件的发生率。
关键词(KeyWords): 心肌梗死;休克;主动脉内球囊反搏
基金项目(Foundation):
作者(Author): 顾俊,胡伟,肖红兵,冯小弟,余强,金贤,尹桂芝,陈诚军,陈跃光,张大东
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