IABP辅助下非体外循环冠状动脉搭桥术治疗重症冠心病的临床分析

Clinical analysis of IABP assisted off-pump coronary artery bypass grafting in treatment of severe coronary heart disease

目的探讨主动脉球囊反搏（IABP）辅助下非体外循环冠状动脉搭桥术治疗重症冠心病的临床效果。 方法将80例重症冠心病患者随机分为两组，每组40例。对照组单纯采用非体外循环冠状动脉搭桥术治疗，观察组采用IABP辅助下非体外循环冠状动脉搭桥术治疗，比较两组治疗相关指标、心功能、并发症发生情况。 结果观察组手术时间、呼吸机支持时间、ICU住院时间、术后血小板减少、术后低心排、中转体外循环及病死率均明显低于对照组，差异有统计学意义（P〈0.05）；术后3个月，两组左室射血分数（LVEF）、左心室舒张末期内径（LVDD）均明显改善，与对照组比较，观察组LVEF水平更高，LVDD水平更低，差异有统计学意义（P〈0.05）。 结论重症冠心病采用IABP辅助下非体外循环冠状动脉搭桥术治疗，能显著缩短治疗时间，改善心功能，降低并发症发生率及病死率。

ObjectiveTo investigate the clinical effects of intra-aortic balloon pump （IABP） assisted off-pump coronary artery bypass grafting （OPCABG） on severe coronary heart disease （CHD）. MethodsEighty patients with severe CHD were randomly divided into two groups, with 40 cases in each group. The patients in control group were given OPCABG, while the patients in observation group were treated by IABP assisted OPCABG. The curative indexes, cardiac function and complications were compared between the two groups. ResultsThe operation time, respirator supporting time, ICU hospital stays, postoperative thrombocytopenia, low cardiac output, conversion to on-pump and death rate in observation group were lower than those in control group （P〈0.05）. After surgery for 3 months, the left ventricular ejection fraction （LVEF） and left ventricular end-diastolic dimension （LVDD） in the two groups improved, and compared with control group, the LVEF level of the observation group was higher and LVDD level was lower （P〈0.05）. ConclusionsIABP assisted OPCABG is effective on severe CHD, which can shorten curative time, improve the cardiac function, and reduce the complications and death rate.