论文部分内容阅读
目的评价在危重冠心病患者经皮冠状动脉介入治疗(PCI)术中联合使用主动脉内气囊反搏(IABP)的有效性及安全性。方法回顾性分析我院心内科2010年9月至2014年6月期间74例危重冠心病患者,PCI术中均联合使用IABP,其中急性心肌梗死合并泵衰竭(Killip III级)或心源性休克(CS)65例,左主干并三支冠状动脉严重狭窄但有外科CABG禁忌症5例,三支冠状动脉严重狭窄并心功能低下4例。结果65例急性心肌梗死合并泵衰竭(Killip III级)或CS患者住院期间死亡22例(33.8%),绝大多数死于泵衰竭,其中11例是PCI术中出现心源性休克后补救性植入IABP的,没有与植入IABP并发症有关的死亡;另外在急性心肌梗死合并泵衰竭(Killip III级)而PCI术前植入IABP的40例患者中无一例死亡。结论危重冠心病患者在PCI术时,尤其是急性心肌梗死合并急性泵衰竭的患者,尽早在PCI术前联合使用IABP是一项安全有效的措施。
Objective To evaluate the efficacy and safety of intra-aortic balloon pump (IABP) in patients with critical coronary artery disease undergoing percutaneous coronary intervention (PCI). Methods A retrospective analysis of 74 cases of critically ill patients with coronary heart disease in our department from September 2010 to June 2014 was performed in our hospital. All patients underwent PCI with IABP. Among them, acute myocardial infarction combined with pump failure (Killip class III) or cardiogenic shock (CS) 65 cases. There were 5 cases of severe left coronary artery stenosis and coronary artery stenosis but 5 cases of surgical CABG contraindications. There were 4 cases of severe coronary artery stenosis and cardiac dysfunction. Results Twenty-two patients (33.8%) died during hospitalization in 65 patients with acute myocardial infarction complicated with pump failure (Killip class III) or CS. Most died of pump failure. Among them, 11 patients were treated with cardiogenic shock after PCI There were no deaths associated with implanted IABP complications in IABP implants; none of the 40 patients with acute myocardial infarction complicated with pump failure (Killip class III) and IABP implanted prior to PCI died. Conclusions In patients with critical coronary artery disease during PCI, especially in patients with acute myocardial infarction complicated by acute pump failure, it is safe and effective to combine IABP as early as possible before PCI.