应用IABP于体外循环中产生搏动血流在高危冠状动脉搭桥病人中的应用

IABP Used for Producing Pulsatile Blood Flow in High Risk Coronary Artery Bypass Grafting Patients.

本文报告2例高危冠心病行冠状动脉搭桥的病人,均为男性,年龄分别为72及69岁,均为三支病变,不稳定心绞痛CCS Ⅳ级,术前例1置入IABP7天,例2为9天,其中例2为急性非Q波心肌梗塞。2例病人均在全麻,微温(32-34℃)体外循环下行冠状动脉搭桥术,术中应用4:1温血停跳液保护心肌,在体外循环期间继续使用IABP,心脏跳动下应用心电R波触发,心脏停跳后改成机内频率,2例病人均搭桥四支,术中CPB时间分别为124和109分,主动脉阻断时间分别为57和43分。术中顺利脱离体外循环机,术后病人恢复顺利。在体外循环期间由于IABP的应用,血压可维持在14-16.67/8-10.67kPa,作者认为,对高危冠状动脉搭桥的病人,体外循环中继续应用I-ABP可产生接近生理值的搏动血流,利于维持足够的心肌灌注和脑灌注。

Intro -aortic balloon pump (IABP) was used to produce pulsatile blood flow during cardiopulmonary bypass (CPB) for two patients with high - risk coronary disease. The 2 patients were male. Age was 72 and 69, respectively. Both were triple vessel diseases, ongoing ischemia- One of them had acute non - Q myoeardial infarction. Under general anes hesia and tepid (32℃ -34℃) CPB, the patients underwent coronary artery bypass grafting (CABG). 4: 1 worm blood cardioplegia used for myoeardial protection. During whole period of the CPB, IABP was kept on for producing pulsatile blood flow, even in aortic cross -clamping time. There were 4 grafts for each patient. CPB time was 124, and 109 rain, respectively. Aortic cross clamping time was 57, and 43 min, respectively. Both of them were weaned from CPB smoothly. The blood pressure was kept at a range of 14 - 16. 67/8 - 10.67 kPa(l kPa = 1.5 mmHg). The postoperative period of the patients was uneventful. The results suggested use of IABP to produce pulsatile blood flow might gain satisfactory blood pressure, which will benefit to myoeardial and brain perfusion.