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应用

目的评价主动脉球囊反搏术(IABP)在急性心肌梗死(AMI)合并心源性休克治疗中的应用价值。方法选取AMI合并心源性休克患者65例,其中IABP组30例,在IABP支持下行急诊经皮冠状动脉介入治疗(PCI),对照组35例,单纯行急诊PCI治疗。结果IABP组患者在IABP支持下,30 min后血流动力学指标改善,2~8 h血流动力学稳定,均完成梗死相关血管再通,没有血管再闭塞事件发生,无术中死亡,院内死亡率40%;对照组患者院内死亡率74.3%,其中6例在术中死亡。结论IABP可明显改善AMI合并心源性休克患者的血流动力学指标,增加冠状动脉的灌注;IABP可提高急诊PCI的成功率,减少术后低心排综合征及血管再闭塞事件的发生,降低院内死亡率,明显改善了AMI合并心源性休克患者的预后。

The role of intra-aortic ballon counterpulsation in acute myocardial infarction with cardiogenic shock

Objective To evaluate the application of intra-aortic balloon counterpulsation(IABP) in acute myocardial infarction(AMI) with cardiogenic shock.Methods The study enrolled 65 AMI patients with cardiogenic shock and all the patients underwent primary PCI treatment.Among them,30 patients had IABP suppont during operations.Results In all the 30 cases with IABP support,the hemodynamic parameters improved in 30 minutes and stabilized in 2-8 hours.There was no reocclusion and death during querations.The death rate of the IABP group during hospitalization was 40%.Among the other 35 patients without IABP support,6 patients died during PCI and the in hospital death rate was 74.3%.Conclusion IABP can improve hemodynamic parameters and the perfusion of coronary artery in patients with cardiogenic shock.It can increase the success rate of primaty PCI,reduce the risk of low cardiac output and reocclusion during operation.IABP support during PCI can also improve the prognosis and reduce the motality rate of AMI patients with cardiogenic shock.