主动脉内球囊反搏术辅助的经皮冠状动脉介入术成功治疗急性广泛前壁ST段抬高型心肌梗死合并心源性休克患者1例

Successful rescueofcardiogenic shock due to extensive anterior wall ST-segment elevation myocardial infarction：a casereport

我科成功救治1例糖尿病、急性广泛前壁ST段抬高型心肌梗死并心源性休克患者。患者以持续性胸痛起病，伴有血压下降、大汗淋漓，心电图、心肌酶谱和冠状动脉造影确诊急性广泛前壁ST段抬高型心肌梗死，治疗过程中又出现急性左心衰、重症肺炎、乳酸酸中毒、酮症酸中毒等并发症。急诊经皮冠状动脉介入术开通前降支，主动脉内球囊反搏术、无创呼吸机支持治疗，之后患者仍有反复发作心衰，肺部感染迁延不愈，最终在冠心病监护病房治疗41d后好转出院。

We successfully rescued a patient suffering from extensive anterior wall ST-segment elevation myocardial infarction（STEMI） complicated with cardiogenic shock on the basis of diabetes mellitus.The initial symptom at onset was persistent chest pain, followed byblood pressuredeclineand profusesweating soon after. Extensive anterior wall STEMI was confirmed by electrocardiography（ECG）, myocardial enzymestestand coronary angiography. Duringthetherapeutic process, he was found complicating withacute leftventricular failure,severe pneumonia, lactic acidosis and diabetic ketoaeidosis. Left anterior descending branch was reopened by emergency percutaneous coronary intervention （PCI）. Intra aortic balloon pump （IABP） and noninvasive ventilator wereemployedfor life support. Heart failure attacked repeatedly and pneumonia was protracted. Finally the patient got better and discharged after 41 days’ therapy in the coronary care unit.