IABP在冠状动脉搭桥术后低心排出量患者中的应用价值及其对心肾功能及血流动力学水平的影响

Application value of IABP in patients with low cardiac output after coronary artery bypass grafting and its effect on cardiac function and hemodynamic level

目的探讨在冠状动脉搭桥术后低心排出量患者中应用主动脉内球囊反搏(IABP)的效果及其对血流动力学水平及心肾功能的影响。方法选取郑州市第七人民医院心外术后重症医学科2019年1月至2021年2月期间107例冠状动脉搭桥术后低心排出量患者作为研究对象,采用随机数字表法分组,对照组53例给予强心、利尿、机械通气等对症治疗与盐酸多巴胺治疗,观察组54例在对照组基础上加用IABP,比较两组心功能、血流动力学、肾功能和并发症发生情况。结果观察组治疗后,中心静脉压(CVP)低于对照组,收缩压(SBP)、舒张压(DBP)高于对照组(P<0.05);观察组治疗后,左室射血分数(LVEF)高于对照组,左心室舒张末期内径(LVDD)低于对照组(P<0.05);观察组治疗后,尿素氮(BUN)、肌酐(Cr)低于对照组,每小时尿量高于对照组(P<0.05);两组患者血小板减少、下肢缺血、心律失常等并发症发生率比较,差异无统计学意义(P>0.05)。结论在冠状动脉搭桥术后低心排出量患者中应用IABP效果确切,能够改善患者血流动力学水平,提高心功能和肾功能,具有临床推广价值。

【Objective】To study the effect of intraaortic balloon counterpulsation(IABP)in patients with low cardiac output after coronary artery bypass grafting and its effect on hemodynamic level and cardiac function.【Methods】A total of 107 patients with low cardiac output after coronary artery bypass grafting were selected from our department from January 2019 to February2021 as the research objects.They were divided into two groups by random number table method.Fifty-three patients in the control group were treated with symptomatic cardioembolism,diuresis,mechanical ventilation and dopamine hydrochloride,and fifty-four patients in the observation group were treated with IABP on the basis of the control group.Cardiac function,hemodynamics,renal function and complications were compared between the two groups.【Results】After treatment,the central venous pressure(CVP)in observation group was lower than that in control group,while the systolic blood pressure(SBP)and diastolic blood pressure(DBP)in observation group were higher than those in control group(P<0.05).After treatment,left ventricular ejection fraction(LVEF)in observation group was higher than that in control group,and left ventricular end-diastolic diameter(LVDD)was lower than that in control group(P<0.05).After treatment,urea nitrogen(BUN)and creatinine(Cr)in observation group were lower than those in control group,and urine volume per hour was higher than that in control group(P<0.05).There was no significant difference in the incidence of thrombocytopenia,lower limb ischemia,arrhythmia and other complications between the two groups(P>0.05).【Conclusion】IABP has a definite effect on patients with low cardiac output after coronary artery bypass grafting,which can improve the level of hemodynamics,cardiac function and renal function,and has clinical promotion value.