主动脉内球囊反搏在心源性休克中的应用进展

Application Progress of Intra-aortic Balloon Pump in Cardiogenic Shock

心源性休克仍是现代医学中最具挑战性的临床疾病之一。机械支持正被越来越多地应用于心源性休克的管理。主动脉内球囊反搏(IABP)是最早和最广泛使用的机械循环支持类型之一。尽管IABP提供的血流动力学支持较新的机械循环支持设备少,但由于其置入和去除相对简单,且需要的血管通路尺寸小、安全性高,在适当的情况下仍可作为机械支持设备。目前的随机试验数据和荟萃分析支持IABP的安全性,但其治疗高危心肌梗死、心肌梗死合并心源性休克或高危经皮冠状动脉介入治疗和冠状动脉旁路移植术预防性使用IABP的数据有限,需要进一步对安放IABP的患者进行筛选、确定IABP安放时机,明确IABP的作用。

Cardiogenic shock remains one of the most challenging clinical diseases in modern medicine.Mechanical support is increasingly being used for the management of cardiogenic shock.Intra-aortic balloon pump(IABP)is one of the earliest and most widely used types of mechanical circulatory support.Although IABP provides less hemodynamic support compared to newer mechanical circulatory support devices,it can still be chosen in appropriate situations due to its relatively simple placement and removal,small required vascular access size,and high safety.The current randomized trial data and meta-analysis support the safety of IABP,but there is limited data on its use in the treatment of high-risk myocardial infarction,myocardial infarction combined with cardiogenic shock,or preventive use in high-risk percutaneous coronary intervention and coronary artery bypass grafting,so it is necessary to further screen the patients undergoing IABP,determine the timing of IABP insertion,and clarify the role of IABP.