主动脉内球囊反搏术于急诊PCI中的应用

目的探讨主动脉内球囊反搏（IABP）支持下急性心肌梗死（AMI）合并心源性休克（CS）患者行急诊经皮冠状动脉介入术（PCI）治疗的临床疗效。方法回顾性分析28例急性心肌梗死并心源性休克患者，于发病0．5～12h内在IABP支持下行急诊冠状动脉造影，对梗死相关血管（IRA）直接行PTCA及支架置入。监测IABP置入对血流动力学参数的影响，并于4周内行心脏超声检查及心功能测定。结果冠状动脉造影示：单支血管病变2例，双支血管病变6例，三支血管病变18例，左主干病变2例。28例患者梗死相关动脉全部再通，23例患者血流达到TIMI3级，5例患者发生慢血流或无复流现象。急诊介入术中死亡2例，介入治疗术后住院期内死亡10例。住院期间总死亡率为42．9％（12／28）。16例存活患者4周时检查射血分数（EF）为0．43-0．67（0．53±0．10）。结论应用IABP可为急性心肌梗死合并心源性休克的患者在行急诊PCI中提供稳定的血流动力学支持。

Application of intra-aortic balloon pump in acute myocardial infarction patients complicated with cardiogenic shock

Objective To investigate the effect of intra-anrtic balloon pump (IABP) on patients with acute myocardial infarction (AMI) complicated with cardiogenic shock (CS). Methods The clinical data of 28 patients with AMI complicated by Cs were collected and the results were statistically analyzed. Results IABP threatment could markedly restore heart rate and blood pressure.The mortality during admission was 42.9%(12/28).The eject fractures of survivers were 43%～67%. Conclusions IABP provides stable hemodynamic supports for AMI patients complicated with cardiogenic shock undergoing primary percutaneous coronary intervention.