术前置入主动脉内球囊反搏对高危冠状动脉旁路移植术患者预后的影响

目的比较高危冠心病患者术前预防性置入主动脉内球囊反搏(IABP)和被动紧急置入IABP对临床预后的影响. 方法 35例接受冠状动脉旁路移植手术同时需接受IABP置入的患者,根据置入的时机不同分为两组.术前置入组 接受术前预防性置入IABP;对照组术中或术后接受紧急置入IABP.比较两组围术期死亡率、心肌梗死发生率、术后心功能不全和需要正性肌力药物辅助的程度、IABP使用的时间、术后呼吸机辅助时间和重症监护治疗病房(ICU)停留时间. 结果术前置入组围手术期死亡率和心肌梗死发生率分别为11.1%和0%,较对照组低(65.4%,50%;P＝0.007,0.013);两组呼吸机辅助通气时间、IABP使用时间、术后需正性肌力药物辅助时间以及术后平均住ICU时间差别均有显著性意义(P＜0.05). 结论术前预防性置入IABP能降低围术期死亡率、心肌梗死发生率,减少对正性肌力药物的需要量和缩短住ICU时间.

The outcome effect of preoperative use of intra-aortic balloon pump in high-risk patients undergoing coronary artery bypass grafting

Objective To compare the clinical outcome effect between the intra-aortic balloon pump (IABP) inserted in the preoperative preventive condition and in the emergency condition for the patients with high-risk undergoing coronary artery bypass grafting(CABG). Methods Thirty-five patients who received the CABG and contemporary need of IABP support were divided into two groups depended on the IABP established time, preoperative group, IABP was inserted at the preoperative time, control group, it was inserted at the emergency condition. Items of comparison between two groups were the perioperative mortality, myocardial infarction rate, severity of postoperative myocardial dysfunction and inotropic drug consumed quantity, IABP support time, ventilation assist time and intensive care unit(ICU) stay time when the IABP was inserted at the different time. Results Perioperative mortality(11.1%) and myocardial infarction rate(0%) in preoperative group were lower than those in control group(65.4%, 50%; P=0.007, 0.013). Simultaneity, the difference in postoperative periods of both groups in ventilation assist time, IABP support time, inotropic drug support time >12 hours, and in the ICU stay time were significant(P<0.05). Conclusions Preoperative preventive insertion of IABP can significantly decrease the perioperative mortality and myocardial infarction rate, the quantity of inotropic drug was reduced and the ICU stay time shortened.