【摘要】 目的:探讨主动脉内球囊反搏(IABP)在重症冠心病患者围手术期的应用时机。方法:回顾分析2003年1月～2009年8月45例重症冠心病患者在围手术期应用IABP的临床资料。根据使用时机不同分为3组:术前组13例,术中组13例,术后组19例,对各组术后呼吸机辅助时间,血管活性药物使用时间,ICU监护时间,术后IABP支持时间,平均心脏指数及手术死亡率等指标进行对比。结果:45例患者均完成冠脉搭桥手术,总手术死亡率为31%,术前组在术后72 h心脏指数明显优于术中组和术后组,呼吸机辅助时间,术后IABP支持时间明显短于术中组和术后组,手术死亡率低于术后组(均P<0.05),术前组患者术后使用血管活性药物时间较术中组和术后组缩短(P<0.05)。结论:IABP是救治重症高危冠心病患者的安全有效手段,对高危患者术前积极应用IABP辅助治疗,可改善心脏功能,增加手术安全性,降低围手术期死亡率。更多还原

【Abstract】 AIM: To retrospectively investigate the timing and effectiveness of perioperative intraaortic balloon pump(IABP) in coronary artery bypass graft(CABG) patients.METHODS: Forty-five patients treated with IABP for severe coronary heart disease(CHD) from January 2003 to August 2009 were divided into three groups according to the time of IABP: preoperative group(n=13),intraoperative group(n=13) and postoperative group(n=19).Perioperative mortality,inotropic drug consumed time,postoperative cardiac index at 72 h,IABP support time,ventilation assist time and intensive care unit(ICU) stay time were analyzed and compared between the three groups.RESULTS: All 45 patients received CABG and total mortality was 31%.In the preoperative group,the postoperative cardiac index at 72 h was better than in both intra-and postoperative groups,whereas the IABP support time,ventilation assist time,length of stay in intensive care unit(ICU),time of intropic drug use and perioperative mortality were much lower than in intra-or postoperative group.CONCLUSION: IABP is a safe and effective mode for circulation support.For severe CHD patients,preoperative IABP is strongly recommended because it improves cardiac function,offers enhanced surgical safety and significantly decreases perioperative mortality.更多还原