动脉内球囊反搏在急诊PCI治疗高血栓负荷病变合并慢血流中的应用研究

The application of intra arterial balloon pump in the treatment of patients with high thrombus burdern in the emergency percutaneous coronary intervention

目的 探讨动脉内球囊反搏在急诊经皮冠状动脉介入（PCI）治疗高血栓负荷病变合并慢血流中的临床疗效.方法 选取2013年11月至2015年5月我院收治的60例急性心肌梗死行经皮冠状动脉腔内血管成形术后高血栓负荷病变合并慢血流患者,随机分成治疗组和对照组,各30例.60例患者均行急诊PCI,其中治疗组患者采取动脉内球囊反搏进行治疗,对照组患者未采用动脉内球囊反搏进行治疗.治疗完成后对60例患者进行随访,评价两组患者的冠状动脉血流状况,并观察患者的血浆活性物质血管性假血友病因子和内皮素-1,以及患者心功能的恢复情况等.结果 与对照组相比,治疗组急诊支架植入术前、急诊支架植入术后的向冠状动脉血流级数及左室射血分数明显高于对照组,而向冠状动脉血流帧数明显低于对照组,两组比较差异具有统计学意义（P＜0.05）.治疗组与对照组在急诊支架植入术前、急诊支架植入术后及急诊支架植入术6个月与经皮冠状动脉介入治疗后相比,向冠状动脉血流级数明显增加,向冠状动脉血流帧数和左室射血分数减低,差异具有统计学意义（P＜0.05）.治疗组不良反应的发生率为16.7％,明显少于对照组的40.0％,两组比较差异具有统计学意义（P＜0.05）.结论 主动脉内球囊反搏在急诊经皮冠状动脉介入治疗高血栓负荷病变合并慢血流中,能在一定程度上改善患者的冠脉血流和心功能.

Objective To investigate the clinical effect of intra arterial balloon pump in emergency per- cutaneous coronary intervention in patients with high blood flow and low blood flow. Methods 60 patients with acute myocardial infarction treated in our hospital from November 2013 to 2015 May were randomly divided into treatment group and control group, 30 cases in treatment group and control group. The treatment group was treated with intra arterial balloon pump, and the control group was treated with intra arterial balloon pump. After treat- ment, 60 patients were followed up for two groups of patients with coronary blood flow condition, and to observe the plasma activity of plasma active substance von factor and endothelin-1 and recovery of heart function of pa- tients. Results The treatment group compared with the control group, the treatment group emergency stent im- plantation before and after stent implantation to the emergency coronary flow series and left ventricular ejection fraction was significantly higher than the control group, and the blood flow to the coronary artery frame was signifi- cantly lower than control group, comparison the difference between the two groups was statistically significant （P〈 0.05 ）. The treatment group compared with the control group and after percutaneous coronary intervention in emer- gency stent implantation before and after stent implantation and emergency stent implantation in 6 months, signifi- cantly increased the blood flow to the coronary artery series, reduced coronary blood flow to frames and the left ventricular ejection fraction, the difference was statistically significant（P〈0.05 ）. The incidence of adverse reactions in the treatment group was 16.7%, which was significantly less than that in the control group, the difference was statistically significant（P〈0.05 ） between the two groups（P〈0.05 ）. Conclusion Intra aortic balloon pump can im- prove the coronary flow and cardiac function in patients with high blood flow and low blood flow.