主动脉内球囊反搏治疗心脏手术围术期低心排15例临床分析

The clinical analysis on the effect of IABP therapy for fifteen patients with perioperative low cardic output syndrome after open heart surgery

目的：探讨主动脉内球囊反搏（IABP）治疗心脏手术围术期低心输出量综合征（低心排）的临床疗效。方法：15例心脏手术围术期低心排患者，均从股动脉放置主动脉内球囊反搏导管于降主动脉内进行IABP治疗，手术前、后监测患者连续有创动脉收缩压（SABP）、有创平均动脉压（MABP）、中心静脉压（CVP）、动脉血氧分压（Pa02）、左心室射血分数（LVEF）、心率（HR）和尿量。结果；IABP辅助治疗时间25-276h，平均（98．1±103．5）h。行IABP治疗后，SABP、MABP、PaO2、LVEF较术前明显提高（P〈0．05），HR、CVP明显下降（P〈0．05），尿量增加，12例患者心功能好转而脱离IABP，11例（73．3％）存活，4例死于多脏器功能衰竭。结论：IABP能明显改善心脏手术围术期低心排患者的血流动力学指标，对有适应证者应尽早应用。

Objective： To investigate the intra-aortic balloon counterpulsation（IABP）for the treatment of low cardiac output syndrome after open heart surgery. Methods： Fifteen patients with perioperative low cardiac output syndrome had been placed IABP catheter through the internal femoral to artery with auxiliary treatment, and continuously measurement of systolic arterial blood pressure （SABP）, average arterial blood pressure （MABP）, central venous pressure （CVP） , pressure artery oxygen （PaOz）, left ventricular ejection fraction （LVEF）, heart rate （HR）, urine. Results： The duration of the IABP assist ranged from 25-276 h, mean （98. 1± 103. 5） h. With the IABP treatment, the patients＇ hemodynamic parameters： SABP, MABP, PaO2, LVEF markedly improved, LVEF （P 〈0.05）, HR, CVP declined （P 〈0.05）, Urine increased. IABP support was successfully withdrawn in twelve patients. Eleven patients （73.3%） were survival. The survival rate was 73.3%. Four patients died of multiorgan failure. Conclusion： IABP can effectively improve the hemodynamic status of patients with perioperative low cardiac output syndrome, IABP is an effective procedure and it should be applied early.