主动脉内球囊反搏在急性心肌梗死合并心源性休克治疗中的临床应用分析

Clinical analysis of intra aortic balloon pump in the treatment of acute myocardial infarction complicated with cardiogenic shock

目的探求主动脉内球囊反博(IABP)在急性心肌梗死(AMI)合并心源性休克(CS)患者中的临床应用价值。方法我院综合ICU(重症医学科)及心内科收治的AMI合并CS患者共计201例为研究对象,根据不同的治疗方案分为两组。观察组共97例,患者入院时先应用IABP进行治疗,待病情稳定后再行择期PCI治疗,对照组予以急诊PCI治疗。统计并分析两组治疗后平均动脉压、心率、尿量改善情况;心脏事件发生情况及死亡率。结果经治疗后观察组平均动脉压、心率、尿量改善情况均优于对照组,差异有统计学意义(P<0.05);心脏事件发生率为8.25%,显著低于对照组的25.96%,差异有统计学意义(P<0.05);在死亡率方面,两组差异无统计学意义(P>0.05)。结论对于AMI并发CS的患者应用IABP治疗可以改善患者的平均动脉压、心率及尿量,并有效降低心脏事件的发生率,在临床上具有一定的治疗意义。

Objective To explore the clinical application value of intra-aortic balloon pump（IABP） in patients with acute myocardial infarction（AMI） complicated with cardiogenic shock（CS）. Methods A total of 201 patients with AMI combined with CS admitted to the ICU（intensive care unit） and department of cardiology in our hospital were selected as subjects and divided into two groups according to different treatment schemes.There were 97 cases in the observation group,the patients were treated with IABP at first when they were admitted to hospital,and then they were treated with selective PCI after their condition was stable.The control group was treated with emergency PCI.The mean arterial pressure,heart rate and urine volume improvement,cardiac events and mortality after treatment in two groups were statistically analyzed. Results After treatment,the mean arterial pressure,heart rate,and urine volume in the observation group were better than those in the control group,and the difference was statistically significant（P〈0.05）.The incidence of cardiac events was 8.25%,which was significantly lower than that of the control group（25.96%）,the difference was statistically significant（P〈0.05）.In terms of mortality,there was no significant difference between the two groups（P〉0.05）. Conclusion The use of IABP therapy for patients with AMI complicated with CS can improve the mean arterial pressure,heart rate and urine volume,and effectively reduce the incidence of cardiac events.It has a certain therapeutic significance in clinical.