心脏手术围术期主动脉内球囊反搏的应用

Perioperative application of the intra-aoctic balloon pump in the cardiac surgery

目的探讨高危心脏病病人围手术期应用主动脉内球囊反搏(IABP)的疗效。方法分析1998年1月至2002年9月293例应用IABP的围手术期心脏病病人资料。结果本组治愈179例,死亡114例,总病死率38·91%;其中冠心病病死率35·87%(94/262例),非冠心病病死率64·52%(20/31例)。术前应用IABP的冠心病者病死率17·24%(5/29例),明显低于术中和术后开始应用IABP的冠心病者病死率36·47%(62/170例)和42·86%(27/63例)。结论IABP是一种安全、行之有效的循环辅助方式,术前应积极应用,在高危冠心病病人中可以明显提高治疗效果。

Objective To discuss the indication and application of intra-aoctic balloon pump （IABP） in high-risk patients undergoing cardiac operations. Methods Analyzed 293 patients undergoing cardiac operation with application of IABP perioperatively from Jan. 1998 to Sep. 2002. Results The total mortality was 38.91% （ 114/293）, the mortality in coronary heart disease patients was 35.87 % （94/262） while in noncoronary heart disease patients was 64.52 % （20/31 ）. In coronary heart disease patients, with the use of IABP preoperatively, the mortality was much lower than those using IABP during were or postoperatively （36.47%, 42.86% respectively）. Conclusion IABP was a safety and effective mode of circulation support. It is beneficial to begin the use of IABP preoperatively in high-risk coronary heart disease patients.