急性心肌梗死合并心源性休克应用主动脉内球囊反搏支持下急诊经冠状动脉介入术的临床研究

Clinical research of emergency percutaneous coronary intervention with intra aortic balloon pump applied in acute myocardial infarction complicated with cardiogenic shock

目的探讨主动脉内球囊反搏支持下急诊经冠状动脉介入术治疗急性心肌梗死合并心源性休克的临床效果。方法选取本院2014年10月~2016年10月急性心肌梗死合并心源性休克患者86例,采用随机数字表法分为两组,对照组患者43例实施急诊经冠状动脉介入术治疗,观察组患者43例实施主动脉内球囊反搏支持下急诊经冠状动脉介入术治疗,比较两组患者治疗前后的临床指标改变情况;并发症情况、预后情况。结果治疗后,两组患者的平均动脉压、心排血量、左室射血分数、心脏指数、每搏输出量增加(P<0.05)。两组患者的心肌肌钙蛋白、肌酸激酶同工酶、心率降低(P<0.05)。观察组患者的平均动脉压、心排血量、左室射血分数、心脏指数、每搏输出量高于对照组(P<0.05),观察组患者心肌肌钙蛋白、肌酸激酶同工酶、心率、总并发症发生率低于对照组(P<0.05)。观察组患者的预后情况好于对照组(P<0.05)。结论主动脉内球囊反搏支持下急诊经冠状动脉介入术治疗急性心肌梗死合并心源性休克的效果显著,可明显改善患者的临床病症与指征,安全性高。

Objective To investigate clinical effect of emergency percutaneous coronary intervention with intra aortic balloon pump applied in acute myocardial infarction complicated with cardiogenic shock.Methods 86 patients with car- diogenic shock complicated with acute myocardial infarction treated in our hospital from October 2014 to October 2016 were selected and they were divided into two groups according to the random number table method.g3 patients received emergency percutaneous coronary intervention were selected as control group.43 patients received emergency percuta- neous coronary intervention with intra aortic balloon pump were selected as observation group.Change of clinical indi- cators before and after treatment,complications,prognosis were compared between two groups.Results After treatment, mean arterial pressure,cardiac output,left ventricular ejection fraction,cardiac index,stroke volume increased in two groups （P〈0.05）.Cardiac troponin,creatine kinase isoenzyme,heart rate decreased in two groups （P〈0.05）.Mean arterial pressure,cardiac output,left ventricular ejection fraction,cardiac index,stroke volume in observation group were higher than control group （P〈0.05）.Cardiac troponin,creatine kinase isoenzyme,heart rate,the total incidence rate of complica- tion in observation group were lower than control group.Prognosis in observation group was better than that in control group （P〈0.05）.Conclusion Emergency percutaneous coronary intervention with intra aortic balloon pump has signifi- cant effect int reatment of cardiogenic shock complicated with acute myocardial infarction,which can significantly im- prove clinical symptoms and signs and it also has high safety.