目的：对急性冠状动脉综合征患者置入主动脉内球囊反搏（IABP）治疗的临床情况和并发症情况进行分析，为IABP的临床应用总结相关临床经验。n 方法：本研究回顾分析2011-01至2012-12在我院急诊及冠心病监护病房置入IABP的急性冠状动脉综合征患者共238例，其中急性ST段抬高型心肌梗死患者159例，非急性ST段抬高型心肌梗死患者30例，不稳定性心绞痛患者49例。收集患者临床资料，分析治疗效果，并对IABP治疗后血小板减少、出血、发热及血栓等并发症发生情况进行分析。n 结果：在使用IABP的238例急性冠状动脉综合征患者中，仅23例（9.7%）未接受冠状动脉介入治疗或冠状动脉旁路移植手术，118例（49.6%）为急性ST段抬高型心肌梗死患者在IABP支持下行介入治疗。死亡和并发症发生情况：死亡21例（8.8%）、血小板减少55例（23.1%）、出血49例（20.5%）、下肢缺血4例（1.7%）。有18例患者发生严重血小板减少（<50×109/L），其中11例拔除IABP后血小板逐渐恢复，5例给予补充了血小板治疗。有12例患者发热，均发生于长时间使用IABP治疗患者，平均置入时间（10.3±7.8）天，有4例患者血培养阳性。n 结论：IABP是急性冠状动脉综合征高危患者的重要过渡辅助装置。血小板减少和出血是最常见并发症。%Objective: To assess the clinical application of intra-aortic balloon pump (IABP) in patients with acute coronary syndrome (ACS) for their treatment and complications. n Methods:A total of 238 ACS patients treated in our hospital from 2011-01 to 2012-12 were studied. There were 159 patients with STEMI, 30 with non-STEMI and 49 with unstable pectoris angina. The clinical information was collected to analyze IABP efficacy and post-IABP platelet deduction, bleeding, fever and thrombosis in all patients. n Results: IABP was applied in all 238 ACS patients. There were 23/238 (9.7%) without PCI or CABG surgery, and 118 (49.6%) STEMI patients received PCI with IABP support. There were 21/238 (8.8%) patients died. And 55 (23.1%) suffered from thrombocytopenia, 49 (20.6%) were with bleeding, 4 (1.7%) with lower limb ischemia. 18 patients had severe thrombocytopenia (platelet < 50 × 109/L), 11 of them recovered gradually after IABP removal and 5 of them received platelet supplement therapy. There were 12 patients with fever, who had IABP implantation at the mean of (10.3 ± 7.8) days and 4 of them had positive blood culture. n Conclusion: IABP is an important assistant device in high-risk ACS patients. Thrombocytopenia and bleeding are the most common complications in clinical practice.
展开▼
