主动脉内球囊反搏对心血管外科手术患者的疗效

Therapeutic effect of intra-aortic balloon pumping for patients undergoing cardiovascular surgery

目的:探讨主动脉内球囊反搏术(IABP)对心血管外科手术患者的疗效。方法:纳入在我院心血管外科ICU中行心脏外科手术治疗的104例患者,按照数字随机法均分为多巴胺组(常规治疗+多巴胺)和IABP组(多巴胺组基础上应用IABP辅助治疗),各52例,观察并比较两组治疗前、术后1周血压,血尿素氮、肌酐,尿量变化,及不良反应发生情况。结果:治疗1周后,与多巴胺组比较,IABP组SBP [(89.24±10.22)mmHg比(104.22±12.63)mmHg]、DBP [(51.14±7.05)mmHg比(64.22±9.25)mmHg]均明显升高,中心静脉压[CVP,(16.04±1.72)cmH2O比(10.23±1.01)cmH2O]、blood BUN [(11.03±1.52)mmol/L比(7.41±0.81)mmol/L]、Cr[(162.23±18.58)μmol/L比(100.84±12.35)μmol/L]水平明显降低,尿量[(44.14±5.69)ml/h比(67.19±8.16)ml/h]明显增多(P均=0.001);IABP组总并发症发生率明显低于多巴胺组(1.92%比48.08%,P=0.001)。结论:对于心脏术后患者,主动脉内球囊反搏术可显著升高血压,增加尿量,降低中心静脉压,血肌酐、尿素氮水平,且术后并发症率显著降低。

Objective:To explore therapeutic effect of intra-aortic balloon pumping(IABP)for patients in ICU of cardiovascular surgery.Methods:A total of104patients,who received cardiac surgery in our ICU of cardiovascular surgery,were enrolled,randomly and equally divided into dopamine group(received routine treatment combined dopamine)and IABP group(received auxiliary IABP based on dopamine group).Blood pressure,levels of blood urea nitrogen(BUN)and serum creatinine(Scr),urine volume before and one week after surgery,incidence of adverse reactions were observed and compared between two groups.Results:Compared with dopamine group on one week after surgery,there were significant rise in levels of SBP[(89.24±10.22)mmHg vs.(104.22±12.63)mmHg],DBP[(51.14±7.05)mmHg vs.(64.22±9.25)mmHg]and urine volume[(44.14±5.69)ml/h vs.(67.19±8.16)ml/h],and significant reductions in levels of central venous pressure[CVP,(16.04±1.72)cmH2O vs.(10.23±1.01)cmH2O],blood BUN[(11.03±1.52)mmol/L vs.(7.41±0.81)mmol/L]and Cr[(162.23±18.58)μmol/L vs.(100.84±12.35)μmol/L]in IABP group,P=0.001all;total incidence rate of complications in IABP group was significantly lower than that of dopamine group(1.92%vs.48.08%,P=0.001).Conclusion:Intra-aortic balloon pumping can significantly raise blood pressure,increase urine volume;reduce blood Scr and BUN levels in patients after cardiac surgery.And its postoperative incidence rate of complications is low.