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目的评价主动脉内球囊反搏术(IABP)对行介入治疗的高危冠心病患者的有效性、患者并发症和住院病死率影响。方法52例高危冠心病患者应用IABP作血流动力学支持,分为择期血运重建组(n=20)和急诊血运重建组(n=28,其中4例进行保守治疗),比较两组临床特征、治疗效果和住院期间不良心血管事件。结果两组患者平均年龄、体重指数及合并高血压、糖尿病比例差异无统计学意义,急诊血运重建组合并心力衰竭、心源性休克比例显著高于择期血运重建组(P<0.01)。IABP平均时间为(82.2±18.0)h,总有效率为86.5%(45/52)。院内病死率为11.5%(6/52)。急诊血运重建组4例死于心源性休克,4例行保守治疗患者中2例死于多器官功能衰竭。18例心源性休克患者中4例(22.2%)死亡。结论IABP与冠脉血管重建术联合治疗高危冠心病患者,可降低住院病死率,提高手术安全性。
Objective To evaluate the effect of intra-aortic balloon pump (IABP) on the efficacy, patient complication and in-hospital mortality of high-risk CHD patients undergoing interventional therapy. Methods Fifty-two patients with high-risk CHD were enrolled in this study. The IABP was used for hemodynamic support. Elective revascularization (n = 20) and emergency revascularization (n = 28) Clinical characteristics, treatment outcome, and adverse cardiovascular events during hospitalization. Results There was no significant difference in average age, body mass index, hypertension and diabetes between two groups. The proportion of emergency revascularization combined with heart failure and cardiogenic shock was significantly higher than that of elective revascularization group (P <0.01). The average IABP time was (82.2 ± 18.0) h, with a total effective rate of 86.5% (45/52). In-hospital mortality was 11.5% (6/52). Emergency revascularization in 4 patients died of cardiogenic shock, 4 cases of conservative treatment in 2 patients died of multiple organ failure. Of the 18 patients with cardiogenic shock, 4 (22.2%) died. Conclusion IABP combined with coronary revascularization in patients with high-risk coronary heart disease can reduce the hospital mortality and improve the safety of surgery.