主动脉内气囊反搏辅助急性心肌梗死介入治疗

Intra-Aortic Balloon Counterpulsation in the Treatment of Acute Myocardial Infarction in Patients with Angioplasty

目的：探讨主动脉内气囊反搏（IABP）对急性心肌梗死（AMI）,尤其是ST段抬高的AMI（STEMI）患者经皮冠状动脉介入治疗（PCI）的临床意义。方法：接受PCI治疗并需要IABP支持的AMI患者52例顺利行冠脉造影检查,其中32例（61.5%）冠脉造影前导管室插入IABP,15例（28.8%）造影后、介入治疗前插入,2例术前（3.8%）床旁插入IABP,3例（5.8%）PCI术后插入,无介入操作相关并发症,无术中死亡。IABP维持24~240h。结果：50例（96.1%）行直接PCI治疗成功,术后梗死相关动脉血流均达TIMIⅡ级,2例（3.8%）未行PCI治疗。52例中4例（7.7%）需要呼吸机支持,1例（1.9%）PCI后停用IABP而死亡。IABP相关并发症为肾功能异常伴血尿1例（1.9%）,下肢缺血2例（3.8%）,局部血肿4例（7.7%）。结论：IABP对血流动力学不稳定的AMI的直接PCI治疗具有较好辅助作用。

Objective： To evaluate the effect of intra-aortic balloon pump （IABP） in the treatment of acute myocardial infarction （AMI）, especially in AMI patients with ST-elevation （STEMI）, and the clinical significance in STEMI patients with percutaneous transluminal coronary intervention （PCI） thereof. Methods： Fifty-two STEMI patients were detected by PCI. Of which 32 cases （61.5%） were used IABP before angiography, 15 （28.8%） were used after angiography. Preoperative IABP was used in 2 patients（3.8%）,and 3 （5.8%）were used after PCI. There were no complications related to interventional procedures operations and no intraoperative deaths in this study. IABP maintained 24-240 h. Results： PCI was successful in 50 cases（96.1%）. The blood flow of infarct-related arteries was reached TIMI-Ⅱ. Four （7.7%） of 52 patients with PCI were used breathing machine, and one case （1.9%） of them dead after stop of IABP. The associated complications were the renal dysfunction with hematuria in 1 patient （1.9%）,lower extremity ischemia in 2 cases （3.8%） and local hematoma in 4 cases （7.7%）. Conclusion： The results suggest that IABP has a good supporting role in the treatment of AMI.