主动脉内球囊反搏术在冠心病外科的临床应用

本文分析了１９７２年至１９９３年冠心病外科术后患者施行主动脉内球囊反搏术（ＩＡＢＰ）６７例（１４．５％）的治疗经验。应用ＩＡＢＰ的适应证包括：①左室室壁瘤较大或合并梗死后室间隔穿孔，左室射血分数低于３０％，以及病变广泛且远端血管较细等；②术中脱离体外循环机有困难；③术后顽固性低心输出量综合征；④围术期心肌梗死。得出如下结论：①预防性ＩＡＢＰ有助于重症冠心病外科术后患者的顺利恢复；②ＩＡＢＰ使术后低心输出量综合征及左心功能不全得以改善，从而降低了手术死亡率。

INTRA-AORTIC BALLOON COUNTERPULSATION IN PATIENTS UNDERGOING CORONARY SURGERY

Intra-aortic balloon counterpulsation(IABP)in 67 patients undergoing coronary or related procedures at our hospital from 1972 through 1993 including prophylactic balloon insertion(20 cases),inability to wean from cardiopulmonary bypass(31 cases),postoperative lowoutput syndrome refractory to medical therapy during intensive care(6 cases),and perioperative myocardial infarction(10 cases)was retrospectively analyzed.The overall major complication rate was 3%.It is concluded that prophylactic balloon insertion is helpful to patients with large left ventricular aneurysm,left ventricular ejection fraction less than 30% ,and triple-vessel disease with poor run-off,and IABP is effective in managing postoperative low-output syndrome thereby reduces the mortality rate.