联合器官支持治疗重症急性心肌梗死37例临床分析

摘要

目的：探讨联合主动脉内球囊反搏术（IABP）、机械通气（MV）、连续性静-静脉血液滤过术（CVVH）治疗合并心源性休克、急性肺水肿、急性肾损伤的重症急性心肌梗死（AMI）患者的临床疗效。方法：回顾性分析2009年1月至2013年12月我科收治的合并心源性休克、急性肺水肿、急性肾损伤的行床旁联合应用IABP、MV、CVVH 治疗的AMI患者37例的临床资料。结果：本组37例患者中死亡11例（29．7％），治疗后平均动脉压、心率、呼吸频率、血氧分压、氧合指数、尿素氮、血清肌酐均较治疗前显著改善（P＜0．05）。结论：联合应用IABP、MV、CVVH 治疗合并心源性休克、急性肺水肿、急性肾损伤等严重并发症的重症 AMI 患者的临床疗效确切，建议尽早使用。%To explore the clinical effect of patients with severe acute myocardial infarction (AMI) complicated by cardiogenic shock , acute pulmonary edema and acute renal injury treated by combining with intra-aortic balloon pumping (IABP), mechanical ventilation(MV) and continuous venous-venous hemofiltration (CVVH). Methods:The clinical data of 37 patients with severe AMI complicated by cardiogenic shock , acute pulmonary edema and acute renal injury treated by combining with IABP , MV and CVVH were analyzed retrospectively from Jan 2009 to Dec 2013. Results:Among the 37 cases,11 cases were dead,and the mortality rate was 29.7%. Compared with the before treated , the MAP , HR , RR , PaO2 , PaO2/FiO2 , BUN and SCr were significantly improved after treatment (all P<0.05). Conclusion:The effect of combined organ supports in treatment for patients with AMI complicated by serious complications is exactly, which should be used as soon as possible.