球囊反搏术在心源性休克患者抢救中的辅助作用

摘要

目的 评价主动脉内球囊反搏术(IABP)在急性心肌梗死合并心源性休克患者抢救中的辅助作用.方法 将同一时期在我院进行抢救的72例急性心肌梗死合并心源性休克患者按照是否行急诊IABP循环支持治疗分为IABP组(36例)和对照组(36例),两组均行经皮冠状动脉介入治疗及常规用药治疗;比较两组患者术后1周、4周、3个月主要心血管不良事件(MACE)的发生率及术后1周的左心室功能.结果 两组患者术后的左心室功能和MACE发生率存在差异,IABP组术后1周的左心室功能明显优于对照组[(42.6±8.1)％vs(39.8±7.9)％,P＜0.05],IABP组1周、4周和3个月的死亡率均低于对照组(30.6％ vs 55.6％,38.9％ vs 63.9％,47.2％ vs 75.0％,均P＜0.05).结论 主动脉内球囊反搏术在急性心肌梗死合并心源性休克患者抢救中能有效改善患者左心室功能及减少主要心血管不良事件的发生率,有效改善心源性休克患者的预后.%Objective To assess the subsidiary therapeutic efficacy of intra-aortic balloon pump (IABP) support in rescuing patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).Methods Thirty-six patients receiving emergency PCI with IABP support were enrolled as the IABP group,and 36 patients receiving emergency PCI without IABP support at the same time were selected as the control group.The rates of major adverse cardiac events (MACE) were evaluated in the two groups one week,4 weeks and 3 months after the operation,respectively.The left ventricular function was also evaluated.Results There was significant difference in the left ventricular function and the rates of MACE between the two groups.The left ventricular function in the first week of the IABP group was better than that in the control group [(42.6±8.1)％ vs (39.8±7.9)％,P＜0.05],and the mortality rates in the first week,the forth week and the third month of the LABP group were lower than those in the control group (30.6％ vs 55.6％,38.9％ vs 63.9％,47.2％ vs 75.0％,all P＜0.05).Conclusion Intra-aortic balloon pump support can improve the left ventricular function and reduce the rate of MACE in rescuing patients with acute myocardial infarction complicated by cardiogenic shock,leading to a better prognosis of cardiogenic shock patients.