应用主动脉内球囊反搏治疗急性心肌梗死并泵衰竭的疗效研究

The Effect of Application of Intra-aortic Balloon Counterpulsation in Treatment of Acute Myocardial Infarction with Pump Failure

目的:探讨采用主动脉内球囊反搏(IABP)辅助经皮冠状动脉介入(PCI)术治疗急性心肌梗死并泵衰竭患者的临床疗效。方法:选择我院2009年1月至2012年1月收治入院的采用IABP辅助下行冠脉造影及PCI术治疗的急性心肌梗死并泵衰竭患者50例(观察组)。另选择我院同期收治的仅使用常规药物的AMI并泵衰竭50例PCI患者为对照组。观察两组患者血压、心率、尿量、临床症状、转归及并发症情况,并进行统计学分析。结果:观察组使用IABP后50例低血压或休克状况,尿量明显增多,心率明显减慢(P<0.01),且顺利通过PCI手术期,痊愈出院,仅5例死亡,成功率90.0%,死亡率10.0%。对照组50例中,37例患者血液动力学得以改善并接受PCI术,13例分别死亡,成功率74.0%,死亡率26.0%。统计学有显著性差异(P<0.01)。结论:IABP辅助治疗下介入治疗急性心肌梗死并泵衰竭病人,可明显降低其心源性死亡率,提高救治成功率,改善生存率,使患者顺利度过围手术期。提示IABP对急性心肌梗死并泵衰竭病人辅助治疗有明显的益处。

Objective： To investigate the use of intra-aortic balloon counterpulsation （IABP） assisted percutaneous coronary intervention （PCI） in the treatment of acute myocardial infarction and clinical efficacy in patients with pump failure. Methods： 50 patients with IABP assisted coronary arteriography and PCI in the treatment of acute myocardial infarction complicated with pump failure in our hospital from Jan. 2009 to Jan. 2012 admitted to hospital patients （observation group）. Selected 50 cases of PCI patients as control group at the same period in our hospital, using only conventional drug AMI and pump failure. Observed blood pressure, heart rate, urine volume of patients in two groups. The clinical symptoms, prognosis and complications were analysed statistical analysis. Results： 50 cases of hypotension or shock, urine volume increased significantly, the heart rate was significantly slower （ P 〈 0.01 ）, and smoothly through the PCI operation period, cured, only 5 cases of death, the success rate was 90%, the mortality rate was 10%. Hemodynamics control group of 37 cases, 50 cases was improved and accepted PCI operation, 13 cases were dead, the success rate was 74%, the mortality rate was 26%. There＇s statistically significant difference （ P 〈 0.01}. Conclusion： Interventional therapy with IABP adjuvant for acute myocardial infarction patients with pump failure, can obviously reduce the cardiac mortality, improve the success rate of treatment, im- prove the survival rate of the patients, successfully passe the operation period. IABP for acute myocardial infarction and pump failure patients adjuvant therapy has obvious.benefits.