体外膜肺氧合联合主动脉内球囊反搏在高危患者经皮冠状动脉介入治疗中的应用

Application of Extracorporeal Membrane Oxygenation Combined with Intra-aortic Balloon Counterpulsation in Percutaneous Coronary Intervention in High-risk Patients

目的评价体外膜肺氧合(ECMO)联合主动脉内球囊反搏(IABP),在高危患者经皮冠状动脉介入治疗(PCI)中的应用效果。方法选择2019年1月-2021年5月来我院就诊,行经皮冠状动脉介入(PCI)治疗的高危患者50例为研究对象,按照随机数字表法分为对照组和观察组,每组25例。对照组在IABP辅助下行PCI术,观察组行ECMO联合IABP辅助下行PCI术,比较两组治疗效果及预后生存情况。结果观察组住院时间、IABP使用时间,以及入院到球囊通过时间均较对照组长(P<0.05);观察组院内死亡率低于对照组,脱机成功率和院外生存率高于对照组(P<0.05);两组术后左心室射血分数均较治疗前改善(P<0.05),观察组术后左心室射血分数优于对照组,但差异无统计学意义(P>0.05);两组平均手术时间和术后并发症比较,差异无统计学意义(P>0.05)。结论高危患者行PCI手术治疗时采取IABP联合ECMO辅助支持的治疗效果更显著,能有效提高患者的生存率,改善其心功能,值得临床借鉴应用。

Objective To evaluate the effect of extracorporeal membrane oxygenation(ECMO)combined with intra-aortic balloon pump(IABP)on percutaneous coronary intervention(PCI)in high risk patients.Methods A total of 50 high-risk patients treated with percutaneous coronary intervention(PCI)in our hospital from January 2019 to May 2021 were selected as the research objects,and they were divided into the control group and the observation group according to the random number table method,with 25 cases in each group.The control group received IABP-assisted PCI,and the observation group received ECMO combined with IABP-assisted PCI.The therapeutic effect and prognosis of the two groups were compared.Results The hospitalization time,IABP use time and the time from admission to balloon passage in the observation group were longer than those in the control group(P<0.05).The in-hospital mortality rate of the observation group was lower than that of the control group,and the offline success rate and out-hospital survival rate of the observation group were higher than those of the control group(P<0.05).The left ventricular ejection fraction in the two groups was improved after treatment(P<0.05).The left ventricular ejection fraction in the observation group was better than that in the control group,but the difference was not statistically significant(P>0.05).There was no significant difference in the average operation time and the probability of postoperative complications between the two groups(P>0.05).Conclusion IABP combined with ECMO adjuvant support is more effective in the treatment of high-risk patients with PCI operation,which can effectively improve the survival rate and cardiac function of patients,and is worthy of clinical reference.