IABP在危重症冠状动脉旁路移植术围手术期的应用

Perioperative Application of the Intra-aortic Balloon Pump in High-risk Patients Undergoing Coronary Artery Bypass Grafting

目的:探讨危重症冠状动脉旁路移植术(CABG)患者围手术期应用主动脉球囊反搏(IABP)疗效。方法:回顾性分析2008年1月至2010年9月40例应用IABP治疗的危重症CABG患者围手术期资料。结果:术前安置IABP 19例,术中安置IABP 10例,术后安置IABP11例。平均IABP辅助时间98.6±48.2小时。32例患者治愈出院,死亡8例,死亡率20.0%。术前安置者死亡率为21.1%,若除外机械并发症原因则死亡率为10.5%;术中安置者死亡率为20.0%;术后安置者死亡率为18.2%。5例出现血小板减少症;1例出现肠系膜动脉栓塞。结论:IABP是一种安全有效的循环辅助方法,积极应用可以明显提高危重症CABG的治疗效果。

Objective：To evaluate effect of the perioperative application of intra-aortic balloon pump（IABP） in high-risk patients undergoing coronary artery bypass grafting（CABG）.Methods：From Jan 2008 to Sep 2010,the data of 40 high-risk patients undergoing CABG with application of IABP were analyzed retrospectively.Results：IABP was applied for 19,10 and 11 cases at pre,intra and post operative period respectively.The total mortality was 20.0 %.The mortality of application of IABP at pre,intra and post operative period were 21.1 %,20.0 % and 18.2 % respectively.However,if the ventricular septal rupture was excluded,the mortality of application of IABP at pre-operative period was only 10.5%.Conclusions：IABP is a safe and effective mode for circulation support.The appropriate and enthusiastic application of IABP perioperatively can improve effect in high-risk patients undergoing CABG.