体外膜肺氧合联合主动脉内球囊反搏在冠状动脉旁路移植术后心功能不全中的应用

Application of the extracorporeal membrane oxygenation combined with the intra-aortic balloon pump in patients with heart failure after coronary artery bypass surgery

目的总结体外膜肺氧合（ECMO）联合主动脉球囊反搏（IABP）在冠状动脉旁路移植（CABG）术后心功能不全中应用的经验。方法对10例CABG术后心功能不全的患者行IABP和ECMO辅助。通过观察患者血压（MAP）和左室射血分数（LVEF）间接评估辅助效果。结果 IABP辅助时间48-200（78.16±27.78）h,ECMO辅助时间24-120（50.12±25.14）h。平均动脉压从（47.54±3.54）mm Hg升至（70.2±8.5）mm Hg（P〈0.01）。左室射血分数（LVEF）从（0.22±0.03）升至（0.55±0.03）（P〈0.01）。结论 CABG术后心功能不全联合使用IABP和ECMO可显著改善心功能,掌握好IABP和ECMO的使用指征和时机是救治危重患者成功的关键。

OBJECTIVE To summary the experience of extracorporeal membrane oxygenation（ECMO） combined with the intra-aortic balloon pump（IABP） used for patients with heart failure after coronary artery bypass surgery（CABG）.METHODS 10 cases with heart dysfunction after CABG were treated by ECMO combined with IABP.Patients＇ blood pressure（MAP） and left ventricular ejection fraction（LVEF） were monitored to assess auxiliary effect.RESULTS IABP assisted time was 48-200（78.16±27.78） h and the ECMO assisted time was 24-120（50.12±25.14） h.After IABP and ECMO assisted,patients＇ mean arterial pressure increased from（47.54±3.54） mm Hg to（70.2±8.5） mm Hg（P〈0.01） and LVEF increased from（0.22±0.03） to（0.55±0.03）（P〈0.01）.CONCLUSION Using IABP combined with ECMO can significantly improve patients＇ cardiac function after CABG.