联合器官支持治疗重症急性心肌梗死37例临床分析

Clinical Analysis of 37 Patients with Severe Acute Myocardial Infarction Treated by Combining Organ Supports

目的:探讨联合主动脉内球囊反搏术(IABP)、机械通气(MV)、连续性静-静脉血液滤过术(CVVH)治疗合并心源性休克、急性肺水肿、急性肾损伤的重症急性心肌梗死(AMI)患者的临床疗效。方法:回顾性分析2009年1月至2013年12月我科收治的合并心源性休克、急性肺水肿、急性肾损伤的行床旁联合应用IABP、MV、CVVH治疗的AMI患者37例的临床资料。结果:本组37例患者中死亡11例(29.7%),治疗后平均动脉压、心率、呼吸频率、血氧分压、氧合指数、尿素氮、血清肌酐均较治疗前显著改善(P<0.05)。结论:联合应用IABP、MV、CVVH治疗合并心源性休克、急性肺水肿、急性肾损伤等严重并发症的重症AMI患者的临床疗效确切,建议尽早使用。

Objective：To explore the clinical effect of patients with severe acute myocardial infarction （AMI） complicated by cardiogenie shock, acute pulmonary edema and acute renal injury treated by combining with intra- aortic balloon pumping （IABP）, mechanical ventilation （MV） and continuous venous-venous hemofiltration （CVVH）. Methods：The clinical data of 37 patients with severe AMI complicated by cardiogenic shock, acute pulmonary edema and acute renal injury treated by combining with IABP , MV and CVVH were analyzed retrospectively from Jan 2009 to Dec 2013. Results：Among the 37 cases, 11 cases were dead,and the mortality rate was 29.7%. Compared with the before treated, the MAP, HR, RR, PaO2, PaO2/FiO2, BUN and SCr were significantly improved after treatment （all P〈0.05）. Conclusion ：The effect of combined organ supports in treatment for patients with AMI complicated by serious complications is exactly, which should be used as soon as possible.