主动脉内球囊反搏在治疗高龄急性心肌梗死伴心源性休克患者的应用

The clinical application of the intro-aortic balloon pump in treating acute myocardial infraction with cardiogenic shock in the elders

目的 评价急性心肌梗死合并心源性休克的高龄患者行急诊冠脉介入治疗辅以主动脉内球囊反搏 (IABP)术的安全性及有效性。方法 10例急性心肌梗死合并心源性休克或泵衰竭高龄患者 ,行急诊冠脉介入治疗辅以主动脉内球囊反搏 (IABP)术 ,观察临床效果及安全性。结果 10例急性心肌梗死高龄患者经急诊冠脉介入及IABP治疗后 ,9例主动脉内舒张压、平均动脉压显著增高 ,分别由术前 ( 32 6 7±2 35 )mmHg和 ( 4 6 11± 4 17)mmHg,上升至术后 ( 10 5 11± 10 8)mmHg,和 ( 86 11± 8 93)mmHg ,(P <0 0 0 1)。临床症状明显好转 ,血流动力学显著改善。 1例死于肾功能衰竭。结论 急性心肌梗死合并心源性休克高龄患者行急诊冠脉介入治疗时 ,联合应用主动脉内球囊反搏 ,可增加冠脉介入治疗安全性 ,降低病死率 ,减少血管再闭塞率 ,提高手术成功率。

Objective To evaluate the safety and efficacy of the intro-aortic balloon pump (IABP) support in the emergency percutaneous coronary intervention(PCI) in acute myocardial infraction with cardiogenic shock in the elders .Methods The clinical efficacy and safety of the IABP support in the emergency PCI in the 10 elder patients with acute myocardial infraction combined with cardiogenic shock were observed.Results The aortic diastolic and mean pressures of 9 elder patients increased after emergency PCI and IABP performance.The clinical symptoms were improved significantly and the hemodynamic were stabilized.One patients died of kidney failure.Conclusion The application of PCI during IABP support in the emergency interventional procedures in the elder patients with acute myocardial infraction combined with cardiogenic shock can increase the safety,and decrease the mortality and re-occlusion rate, increase the success rate of the procedures.