主动脉球囊反搏联合参附注射液对急性心肌梗死合并泵衰竭行PCI治疗患者的疗效观察

摘要

目的：分析主动脉球囊反搏联合参附注射液对急性心肌梗死合并泵衰竭行冠状动脉介入治疗的临床疗效。方法选择2013年1月~2015年12月在咸阳市中心医院心血管内科诊治的急性心肌梗死合并泵衰竭患者90例，将其随机分为主动脉球囊反搏术组（41例）和多巴胺组（49例），主动脉球囊反搏术组给予主动脉球囊反搏术联合参附注射液治疗，多巴胺组给予多巴胺治疗。观察并记录两组患者的住院时间、维持血流动力学稳定所需时间和围手术期并发症的发生情况；检测收缩压（SBP）、肺毛细血管嵌压（PCWP）、平均肺动脉压（MPAP）和心脏排血指数（CI）。结果与多巴胺组相比，主动脉球囊反搏术组的纠正心力衰竭成功率明显升高（P＜0.05），而住院时间、维持血流动力学稳定所需时间和死亡率均明显降低（P＜0.05）；治疗后两组MPAP和PCWP均明显降低（P＜0.05），SBP和CI均明显升高（P＜0.05），而主动脉球囊反搏术组MPAP、PCWP、SBP和CI的改善程度明显优于对照组（P＜0.05）。结论主动脉内球囊反搏术联合参附注射液能明显改善急性心肌梗死合并泵衰竭患者的血流动力学，较多巴胺疗效优越。%Objective To investigate the curative effect of intra-aortic balloon pump combined with Shenfu injection in treatment of acute myocardial infarction complicated with pump failure during percutaneous coronary intervention.Methods 90 patients with acute myocardial infarction complicated with pump failure treated in Xianyang Central Hospital from January 2013 to December 2015 were divided into intra-aortic balloon pump group (41 patients) and dopamine group (49 patients).The intra-aortic balloon pump group was treated with intra-aortic balloon pump combined with Shenfu injection, the dopamine group was treated with dopamine. The hospital stays, the hemodynamics stabilization and perioperative complications were observed. The systolic blood pressure (SBP), pulmonary capillary wedge pressure (PCWP), mean pulmonary artery pressure (MPAP) and cardiac index (CI) were detected.Results Compared with the dopamine group, the success rate of the intra-aortic balloon pump group increased significantly(P<0.05), the time of hospital stay, the hemodynamics stabilization and mortality were significantly reduced(P<0.05);after treatment, MPAP and PCWP were significantly lower(P<0.05), SBP and CI were significantly higher(P<0.05), especially in intra-aortic balloon pump group (P<0.05).Conclusion The intra-aortic balloon pump combined with Shenfu injection can obviously improve the hemodynamics in acute myocardial infarction with pump failure patients, more effective than dopamine.