冠脉搭桥术后应用IABP时冠脉近端血流速度的变化

Alterations of the Blood Flow Velocity of Coronary Arteries during Intra-aortic Balloon Counterpulsation

目的：研究应用主动脉内球囊反搏泵（ＩＡＢＰ）对冠状动脉搭桥手术（ＣＡＢＧ）后冠状动脉近 端血流速度的影响。方法：对ＣＡＢＧ术后应用ＩＡＢＰ的１１例病人，经食道彩色多谱勒超声监测 ＣＡＢＧ术后应用ＩＡＢＰ在１：１气囊搏动情况下冠状动脉近端血流速度的情况，同时应用持续左心 功能监测仪（ＣＣＯ）观察血流动力学的变化。结果：ＩＡＢＰ明显增加冠状动脉血流均值和峰相血流 速度，舒张期流速和主动脉内平均流速于应用ＩＡＢＰ后明显加快（Ｐ＜０．０５）；ＣＣＯ结果显示心排量 （ＣＯ）和心脏指数（ＣＩ）于应用ＩＡＢＰ后即有增加的趋势，２小时明显恢复，４８小时已经恢复到术前 水平。结论：ＩＡＢＰ无可争议地增加了冠状动脉近端血流速度，使ＣＡＢＧ术后左心功能恢复加快。

Objective: To evaluate the effect of intra - aortic balloon counterpulsation( IABP) on the proximal blood flow velocity of the coronary artery after coronary artery bypass grafting (CABG). Methods: The proximal blood flow velocity of the coronary artery and cardiac output during IABP of 1:1 mode were evaluated by transesophageal echocardiography and continuous cardiac output monitoring respectively in 11 patients after CABG. Results: Both of the mean and peak blood flow velocity of the coronary artery were significantly increased during IABP. The CO and cardiac index (CI) were also markedly increased immediately after applying IABP and recovered to the preoperative level 48h after IABP. Conclusions: IABP can undoubtedly increase the proximal blood flow velocity of the coronary artery and help for improving left cardiac performance after CABG.