体外膜肺氧合对急性心肌梗死合并心源性休克患者生命体征及累积液体平衡的影响

Effects of extracorporeal membrane oxygenation on vital signs and cumulative fluid balance in patients with acute myocardial infarction complicated with cardiogenic shock

目的探讨体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)对急性心肌梗死合并心源性休克治疗的效果及其对患者生命体征、累积液体平衡的影响。方法选用2019年5月—2022年5月开封市中心医院接收的80例急性心肌梗死合并心源性休克患者,随机分为研究组、常规组。常规组给予球囊反搏(IABP)治疗,研究组在常规组的基础上采用ECMO进行治疗。比较两组患者生命体征各项指标、累积液体平衡量及相关并发症发生率和预后情况。结果经过不同方案治疗后,研究组心率、中心静脉压较常规组明显下降(P<0.05),平均动脉压、左心室射血分数(LVEF)较常规组明显上升(P<0.05);治疗后,两组3d内每日累积液体平衡量均降低,且研究组较常规组下降更快(P<0.05);两组并发症发生率无显著性差异(P>0.05),但研究组存活率明显高于常规组(P<0.05),院内病死率明显低于常规组(P<0.05)。结论对急性心肌梗死合并心源性休克患者采用ECMO支持技术治疗,效果较为理想,临床应用价值较高。

Objective To investigate the therapeutic effect of extracorporeal membrane oxygenation(ECMO)on acute myocardial infarction with cardiogenic shock,and its effects on the vital signs and cumulative fluid balance of patients.Methods Eighty patients with acute myocardial infarction complicated with cardiogenic shock who were admitted in our hospital from May 2019 to May 2022 were randomly separated into research group and conventional group.The conven⁃tional group received intra-aortic balloon pump(IABP)treatment,while the research group received ECMO treatment on the basis of the conventional group.The vital sign indicators,cumulative fluid balance,incidence of related compli⁃cations,and prognosis of the two groups were compared.Results After different treatment schemes,the heart rate and central venous pressure in the research group were obviously lower than those of the conventional group(P<0.05),the mean arterial pressure and left ventricular ejection fraction(LVEF)were obviously higher than those of the conventional group(P<0.05);after treatment,the daily cumulative fluid balance decreased in both groups within 3 days,and the research group showed a faster decrease than that of the conventional group(P<0.05);there was no obvious difference in the incidence of complications between the two groups(P>0.05),but the survival rate of the research group was ob⁃viously higher than that of the conventional group(P<0.05),and the hospital mortality rate was obviously lower than that of the conventional group(P<0.05).Conclusion ECMO support technique has ideal effect and high clinical ap⁃plication value for patients with acute myocardial infarction complicated with cardiogenic shock.