探讨主动脉内球囊反搏对冠状动脉搭桥手术后冠状动脉近端血流速度的影响

Investigation of the influence on intra-aortic balloon pump in the use of proximal coronary blood flow velocity after coronary artery bypass grafting

目的探讨主动脉球囊反搏对冠状动脉搭桥手术后冠状动脉近端血流速度的影响,为临床推广做出指导。方法对24例传统心脏停跳冠脉搭桥术后患者应用IABP,并经食管彩色多普勒超声监测冠状动脉近端血流速度,应用有创血压、漂浮导管监测血流动力学指标,记录并比较IABP置入前后指标的变化。结果 (1)IABP显著改善冠状动脉近端血流,主动脉内平均流速和舒张期流速均明显增快(P<0.05);(2)IABP置入后心输出量(CO)、心脏指数(CI)、平均体动脉压(MAP)显著增加(P<0.05),肺动脉楔压(PCWP)、平均肺动脉压(mPAP)显著下降(P<0.05)。结论IABP能够显著增加冠状动脉近端血流速度,改善CABG术后心功能,是一种有效的循环辅助手段。

Objective To investigate the influence of intra-aortic balloon pump in the use of proximal coronary blood flow ve-locity after coronary artery bypass grafting,which made guidance for clinical application. Methods Selected 24 cases patients used intra-aortic balloon pump,and monitored the proximal coronary blood flow velocity by Color Doppler ultrasound. Results （1）IABP significantly improve coronary blood flow in the proximal.The average velocity of intra-aortic and diastolic velocity were significantly faster（P〈0.05）;（2）The cardiac output and cardiac index and mean arterial pressure increased significantly after IABP （P〈0.05）. The pulmonary capillary wedge pressure and mean pulmonary artery pressure decreased significantly after IABP（P〈0.05）. Conclusion IABP is an effective circulation auxiliary means to significantly increase proximal coronary blood flow velocity and improve heart function after CABG.