主动脉内球囊反搏在急性心肌梗死合并心源性休克治疗中的临床应用

目的评价主动脉内球囊反搏（IABP）在急性心肌梗死（AMI）合并心源性休克（CS）治疗中的有效性及安全性。方法对22例接受IABP治疗的AMI合并CS患者,观察其临床效果及安全性。结果 22例患者中,有20例患者接受急诊或择期PCI治疗,大部分患者经IABP治疗后,其血流动力学改善,平均动脉压从术前（57.97±8.36）mmHg升至术后（74.40±5.81）mmHg,临床症状好转,死亡6例,2例死于泵衰竭（均未接受PCI治疗）,2例患者死于心脏猝死,1例死于大面积脑梗死,1例死于失血性休克;1例患者在IABP辅助治疗中出现血小板严重减少。结论对AMI合并CS患者及时行IABP辅助治疗,尤其尽早联合应用PCI实现血流再灌注,可明显改善患者的血流动力学状态及临床症状,降低患者死亡率,改善患者预后,疗效安全可靠。

Clinical Application of Intra-aortic Ballon Pump Support in Patients with Acute Myocardial Infarction Presenting in Cardiogenic Shock

Objective To evaluate the efficacy and reliability of intra-aortic ballon pump(IABP)support in patients with acute myocardial infarction(AMI)presenting in cardiogenic shock(CS).Methods 22 patients of AMI with CS treated with IABP were investigated on the clinical efficacy and reliability.Results Among those 22 patients,20 cases were received emergency or selective PCI.After treatment,most patients had improvement in hemodynamic profile with mean arterial blood pressure from(57.971±8.36)mmHg before treatment to(74.4±5.8)mmHg after treatment,also in clinical symptom.Mortality occurred in 6 patients,2 cases of who due to pump dysfunction,2 cases cardiac stroke,1 case large area cerebral infarction,1 case hemorrhagic shock.Thrombocytopenia occurred in 1 case receiving IABP support.Conclusion Promptly IABP support in patients with AMI presenting in CS especially combination with PCI reperfusion,had a pretty efficacy and reliability,great improvement in hemodynamic profile and clinical symptom,also decreasing the mortality and improving the prognosis.