论文部分内容阅读
目的:探讨早期主动脉内球囊反搏(IABP)植入在急性心肌梗死(AMI)合并心源性休克(CS)患者救治中的价值。方法140例主动脉内球囊反搏联合急诊经皮管状动脉介入治疗(PCI)治疗的AMI合并CS患者,按照发生CS至IABP入的时间,分为:A组为CS至IABP辅助治疗时间<3 h,B组为>3 h;观察指标为靶血管、冠脉病变情况等,并记录总IABP辅助时间,死亡、急性呼吸衰竭、急性肾功能衰竭等临床事件。结果两组间基线情况、靶血管病变、静脉用药等无统计学差异;A组三支病变比率、无复流发生率低于B组,但无统计学差异;A组总IABP辅助时间、全因病死率低于B组,有统计学差异,P<0.05;A组心源性死亡、急性呼吸发生率、急性肾衰发生率均低于B组,但无统计学差异。结论在AMI合并CS的患者尽早应用IABP联合血运重建可能有助于改善生存率。“,”Objective To investigate the effect of early Intra-aortic balloon pumping (IABP) support combined emergency intervention in patients of acute myocardial infarction (AMI) complicated with cardiac Shock (CS). Methods Clinical data of AMI complicated with cardiac shock in 140 cases of IABP combine with emergency percutaneous coronary intervention (PCI) admitted in Navy General Hospital of the PLA in between January 2011 and December 2012 were collected and divided into two groups according to the time from CS to IABP. The time interval in group A (n=61) was less than 3 hours and group B (n=79) were more than 3 hours. The target coronary artery, the number of culprit vessel, the total time of IABP treatment, hospital mortality, acute respiratory failure, acute renal failure were observed. Results No statistical significance in the rates of triple vessel disease, no-reflow, cardiogenic death, acute respiratory failure and acute renal failure was found between the two groups even although they all reflected lower in group A than group B. The Total IABP support time of Group A was 70.4 h, significantly shorter than that of Group B (108.1 h, P<0.05). The all-cause mortality of Group A was 14.8%, significantly lower than that of Group B (29.1%, P <0.05). Conclusion An early application of IABP combined with emergency PCI may improve survival rate in patients with AMI complicated with cardiogenic shock.