预防性置入主动脉内球囊反搏应用于高危冠心病行冠状动脉旁路移植术患者的临床疗效分析

Clinical Efficacy Analysis of prophylactic intra-aortic Balloon Pump in high-risk coronary Heart Disease Patients undergoing coronary Artery Bypass Grafting

目的分析高危冠心病行冠状动脉旁路移植术术前预防性置入主动脉内球囊反搏(IABP)的临床疗效。方法围绕南阳医学高等专科学校第一附属医院2020年12月至2022年12月期间收治62例高危冠心病患者展开研究;依据患者手术情况进行分组(对照组、实验组各31例),两组患者治疗术式均为冠状动脉旁路移植术。对照组置入IABP的时机为术中或术后,实验组置入IABP时机则为术前。比较两组治疗有效率、治疗前后心功能指标变化情况、术后恢复指标及术后并发症发生情况。结果实验组治疗有效率(96.77%)高于对照组(80.65%),差异有统计学意义(P<0.05)。治疗前,两组心功能指标对比,差异无统计学意义(P>0.05);治疗后,两组心输出量(CO)、每搏输出量(SV)、左室射血分数(LVEF)均高于治疗前,左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)均低于治疗前,实验组CO、SV、LVEF高于对照组,LVESD、LVEDD低于对照组,差异有统计学意义(P<0.05)。实验组IPBP支持时间、机械通气维持时间、ICU监护时间、住院总时长均短于对照组,差异有统计学意义(P<0.05);实验组术后并发症发生率(6.45%)低于对照组(29.03%),差异有统计学意义(P<0.05)。结论预防性置IABP应用于高危冠心病行冠状动脉旁路移植术患者的临床疗效,有利于改善预后,在术后康复、减少术后并发症等方面均有突出体现,值得应用。

Objective To analyze the clinical efficacy of prophylactic intra-aortic balloon pump(IABP)before coronary artery bypass grafting in high-risk coronary heart disease.Methods A study was conducted on 62 high-risk coronary heart disease patients admitted to the First Affiliated Hospital of Nanyang Medical College from December 2020 to December 2022;According to the surgical conditions of the patients,they were divided into two groups(control group and experimental group,each with 31 cases),and both groups underwent coronary artery bypass grafting surgery.The timing for the placement of IABP in the control group is intraoperative or postoperative,while the timing for the placement of IABP in the experimental group is preoperative.The treatment efficacy,changes in cardiac function indicators before and after treatment,postoperative recovery indicators,and incidence of postoperative complications were compared between two groups.Results The effective rate of treatment in the experimental group(96.77%)was higher than that in the control group(80.65%),and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in cardiac function indicators between the two groups(P>0.05);After treatment,the cardiac output(CO),stroke output(SV),and left ventricular ejection fraction(LVEF)of both groups were higher than those before treatment,while the left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)were lower than those before treatment.The CO,SV,and LVEF of the experimental group were higher than those of the control group,while LVESD and LVEDD were lower than those of the control group,and the difference was statistically significant(P<0.05).The experimental group had shorter IPBP support time,mechanical ventilation maintenance time,ICU monitoring time,and total hospital stay compared to the control group,with statistically significant differences(P<0.05);The incidence of postoperative complications in the experimental group(6.45%)was lower than that in the control group(29.03%),and the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of prophylactic placement of IABP in patients undergoing coronary artery bypass grafting for high-risk coronary heart disease is beneficial for improving prognosis.It has outstanding performance in postoperative rehabilitation and reducing postoperative complications,and is worthy of application.