主动脉球囊反搏治疗急性心肌梗死合并泵衰竭的疗效

摘要

目的：探讨主动脉球囊反搏（IABP）治疗急性心肌梗死（AMI）合并泵衰竭的效果。方法：回顾性分析我院2010年1月至2013年10月急诊经皮冠状动脉介入（PCI）治疗的82例 AMI 合并泵衰竭患者的临床资料，根据是否使用 IABP 辅助治疗分为两组：IABP 组（42例，在 IABP 辅助下行 PCI 治疗）和常规 PCI 组（40例，仅采用常规 PCI 治疗），比较两组患者治疗成功率，死亡率，血流动力学（收缩压、舒张压、心率）稳定至 PCI 时间，住院时间及并发症等情况。结果：与常规 PCI 组比较，IABP 组治疗后血压显著升高[收缩压：（80.3±16.2）mmHg比（88.4±12.5）mmHg，舒张压：（55.4±10.2）mmHg 比（60.0±10.5）mmHg]，心率显著降低[（92.4±26.1）次/min 比（80.5±18.5）次/min]，P 均＜0.05；尿量显著增多[（30.2±8.3）ml/h 比（40.3±9.4）ml/h]（P ＝0.001）；IABP 组治疗成功率显著升高（72.5％比83.3％），死亡率显著降低（27.5％比16.7％），血流动力学稳定至 PCI 时间[（10.1±8.1）h 比（5.0±2.5）h]及住院时间[（18.4±6.2）d 比（13.5±4.2）d]均显著缩短（P均＜0.05）；两组并发症差异无统计学意义（P ＞0.05）。结论：主动脉内球囊反搏辅助治疗 AMI 合并泵衰竭有助于提高 PCI 治疗的成功率，改善血流动力学情况，增加尿量，缩短住院时间。%Objective:To explore the therapeutic effect of intra-aortic balloon counterpulsation (IABP)on acute my-ocardial infarction (AMI)complicated pump failure.Methods:Clinical data of 82 AMI patients complicated pump failure,which received emergency percutaneous coronary intervention (PCI)in our hospital from Jan 2010 to Oct 2013,were retrospectively analyzed.The patients were divided into IABP group (n=42,received PCI with auxiliary IABP)and routine PCI group (n=40,only received routine PCI therapy).Success rate of treatment,mortality,he-modynamic conditions [systolic blood pressure (SBP),diastolic blood pressure (DBP)and heart rate (HR)]stable to PCI time,length of hospital stay and complications were compared between two groups.Results:Compared with routine PCI group after treatment,there were significant rise in blood pressure [SBP: (80.3± 16.2)mmHg vs. (88.4±12.5)mmHg,DBP:(55.4±10.2)mmHg vs.(60.0±10.5)mmHg]and urine volume [(30.2±8.3)ml/h vs.(40.3±9.4)ml/h],and significant reduction in HR [(92.4±26.1)times/min vs.(80.5±18.5)times/min] in IABP group,P <0.05~<0.01;there was significant increase in success rate (72.5% vs.83.3%),and signifi-cant decrease in mortality rate (27.5% vs.16.7%),time stable to PCI for hemodynamical condition [(10.1±8.1) h vs.(5.0±2.5)h]and length of hospital stay [(18.4±6.2)d vs.(13.5±4.2)d]in IABP group,P <0.05 all;incidence rate of complications was no significant difference between groups (P >0.05).Conclusion:IABP adjuvant treatment helps to raise success rate of PCI,improve hemodynamic condition and increase urine volume,shorten length of hospital stay in patients with AMI complicated pump failure.