老年心脏重症患者主动脉内球囊反搏术的应用及预后分析

目的探讨老年心脏重症患者主动脉内球囊反搏术（intra-aortic balloon pumpI,ABP）治疗的应用、临床预后及并发症。方法回顾性分析我院老年病房接受IABP治疗的48例患者的临床资料。将患者分为死亡组及存活组,分析治疗效果的相关因素及并发症。结果接受IABP治疗患者总病死率39.6%;存活组再血管化成功率为62.1%,明显高于死亡组26.3%;而有陈旧性心梗病史率低于死亡组（P〈0.01）。总并发症率16.7%,以出血最常见。此外,多因素Logistic回归分析,结果表明陈旧性心梗史、心源性休克与院内病死率正相关,而成功再血管化则与其负相关。结论老年人心源性休克、陈旧性心梗史及成功再血管化是影响老年人心血管重症接受IABP治疗院内病死率的重要因素。

Intra-aortic balloon pump application and outcomes in elderly patients

Objective To analyze the outcomes and complications of the intra-aortic balloon pump(IABP) in elderly patients with severe heart disease.Methods A retrospective study of 48 consecutive patients who received IABP therapy was conducted.Based on prognosis,two groups were defined: surviving group and non-surviving group.Results The overall mortality was 39.6%,There was a higher rate of successful revascularization(62.1% versus 26.3%) and fewer cases of previous myocardial infarction history(10.3% versus 47.4%) in surviving group than in non-survival group(P<0.05).Previous myocardial infarction,cardiogenic shock as well as successful revascularization were independent predictors of in-hospital mortality in elderly patients requiring IABP placement.Moreover,major IABP-induced complications were 16.7% and bleeding was the most common adverse event.Conclusions Aortic balloon counterpulsation is successfully and safely employed to support elderly severe heart disease patients with rare complications.Previous myocardial infarction,cardiogenic shock as well as successful revascularization are independent predictors of in-hospital mortality.