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[目的]探讨主动脉球囊反博联合机械通气治疗急性心肌梗死合并心源性休克的疗效。[方法]2010年8月～2011年5月期间,某科共收治急性心肌梗死合并心源性休克患者39例,联合应用主动脉球囊反博与机械通气对他们进行治疗,现回顾分析上述患者的临床资料。[结果]①39例急性心肌梗死合并心源性休克患者康复出院12例,治疗有效率为30.8%;院内死亡27例,死亡率69.2%。②康复出院的12例患者,治疗后平均动脉压、动脉血氧分压、pH显著高于治疗前,而中心静脉压显著低于治疗前,治疗前后比较差异具有统计学意义(P均﹤0.05)。③27例患者死亡原因包括多脏器功能衰竭16例,重症感染5例,室间隔穿孔4例,乳头肌断裂3例,左心室游离壁破裂1例。[结论应用主动脉球囊反博联合机械通气治疗急性心肌梗死合并心源性休克有一定的疗效,但死亡率仍然较高;多脏器功能衰竭是急性心肌梗死合并心源性休克患者的主要死亡原因。
[Objective] To investigate the effect of aortic balloon anti-Bo combined mechanical ventilation on acute myocardial infarction with cardiogenic shock. [Methods] From August 2010 to May 2011, 39 patients with acute myocardial infarction complicated by cardiogenic shock were treated in a department. They were treated with aortic balloon anti-Bo and mechanical ventilation. We retrospectively analyzed the above The patient’s clinical data. [Results] Among the 39 patients with acute myocardial infarction complicated with cardiogenic shock, 12 were discharged from hospital, the effective rate was 30.8%. There were 27 in-hospital and 69.2% mortality rates. ② In 12 patients discharged from hospital, the mean arterial pressure, arterial oxygen pressure and pH were significantly higher after treatment than those before treatment, while the central venous pressure was significantly lower than before treatment (P <0.05) ). The causes of death in 27 patients included 16 cases of multiple organ failure, 5 cases of severe infection, 4 cases of ventricular septal perforation, 3 cases of papillary muscle rupture and 1 case of left ventricular free wall rupture. [Conclusion The application of aortic balloon anti-Bo combined mechanical ventilation in the treatment of acute myocardial infarction with cardiogenic shock has a certain effect, but the mortality rate is still high; multiple organ failure is the main myocardial infarction patients with cardiogenic shock cause of death.