主动脉内球囊反搏辅助下非体外循环冠状动脉搭桥手术治疗重症冠心病的临床价值

Clinical Value of Off-Pump Coronary Artery Bypass Grafting Assisted by Intra-Aortic Balloon Counterpulsation in the Treatment of Severe Coronary Heart Disease

目的 探讨主动脉内球囊反搏辅助下非体外循环冠状动脉搭桥手术用于重症冠心病患者的临床价值。方法 选择2021年1月—2023年6月在辽阳市中心医院接受治疗的重症冠心病患者68例作为研究对象,随机分为对照组和观察组各34例。对照组实行非体外循环冠状动脉搭桥手术治疗,观察组实行主动脉内球囊反搏辅助下非体外循环冠状动脉搭桥手术治疗,比较两组治疗前和治疗3d后的血流动力学指标和血清相关指标。结果 治疗后,观察组磷酸肌酸激酶同工酶、心肌肌钙蛋白I、可溶性生长刺激表达基因2蛋白、脂蛋白相关磷脂酶A2低于对照组,差异有统计学意义(P<0.05)。观察组心率、中心静脉压低于对照组,而平均动脉压、左心室射血分数、心输出量、心脏指数高于对照组,差异有统计学意义(P<0.05)。结论 主动脉内球囊反搏辅助非体外循环冠状动脉搭桥手术可以有效改善重症冠心病患者血流动力学指标,改善心肌损伤程度,利于患者心脏功能的早期康复,是理想的治疗方案。

Objective To explore the clinical value of off-pump coronary artery bypass grafting assisted by intra-aortic balloon counterpulsation in patients with severe coronary heart disease.Methods A total of 68 patients with severe coronary heart disease who received treatment in Liaoyang Central Hospital from January 2021 to June 2023 were selected as the study subjects.After admission coding,odd numbered patients were selected as the control group and underwent off-pump coronary artery bypass surgery.The even numbered l patients were selected as the observation group and performed off-pump coronary artery bypass grafting assisted by intra-aortic balloon counterpulsation.The hemodynamic and serum related indicators were compared between two groups before and after 3 days of treatment.Results After treatment,the observation group showed significantly lower levels of phosphocreatine kinase isoenzyme,cardiac troponin I,soluble growth stimulating gene 2 protein,and lipoprotein related phospholipase A2 compared to the control group(P<0.05).The heart rate and central venous pressure of the observation group were significantly lower than those of the control group,while the mean arterial pressure,left ventricular ejection fraction,cardiac output,and cardiac index were significantly higher than those of the control group(P<0.05).Conclusion Intra-aortic balloon counterpulsation assisted off-pump coronary artery bypass grafting can effectively improve blood flow in patients with severe coronary heart disease.