重症冠心病患者住院期间IABP不同脱机策略的临床效果分析

The Clinical Effect of the Different Intra-Aortic Balloon Pump Weaning Protocols during Hospitalization of the Patients with Severe Coronary Artery Disease

目的比较重症冠心病患者主动脉气囊反搏泵采用不同反搏比脱机策略的临床效果差异。方法研究收集2007年10月至2011年12月在我院行主动脉球囊反搏泵(intra aortic balloon pump,IABP)置入术的63例重症冠心病患者的临床资料,进行回顾性分析,比较1∶1→1∶2策略组与1∶1→1∶2→1∶4策略组之间在全因死亡率、心血管相关死亡率、血肿和血栓栓塞发生之间的差异。结果两组患者之间基线资料无明显差异,应用主动脉气囊反博泵的适应证构成无明显差异,两组患者脱机前药物使用相同,两组患者脱机时血流动力学参数相同。两组之间IABP置入术的并发症和死亡率无明显差异,但1∶1→1∶2→1∶4策略组有增加住院时间趋势(P<0.05)。结论 1∶1→1∶2→1∶4脱机较1∶1→1∶2脱机在血流动力学和死亡率方面无更多获益,但住院时间可能延长。

Objective To compare the clinical effect of the different Intra-Aortic Balloon Pump weaning protocols during hospitalization of the patients with severe coronary artery disease.Method Clinical information of 63 consecutive patients treated with IABP between October 2007 and December 2010 was retrospectively collected.The primary and secondary end-points were compared between groups used 1∶1→1∶2 and 1∶1→1∶2→1∶4 weaning protocols.Results There was no significant difference in baseline,IABP indications,hemodynamic improvement,medications at initiation of weaning,complications and mortality between the two groups.1∶1→1∶2→1∶4 weaning increased significantly length of stay(P&lt;0.05).Conclusions 1∶1→1∶2→1∶4 weaning can not offer better benefits in hemodynamics and in-hospital mortality rates than 1∶1→1∶2weaning do.However,1∶1→1∶2→1∶4 weaning is associated with length of stay.