超声引导床旁主动脉内气囊反搏抢救心源性休克

目的:探讨床旁超声引导下主动脉内气囊反搏植入术(IABP)的可行性及对心源性休克的疗效.方法:17例心源性休克患者,在床旁植入主动脉反搏气囊,并通过超声精确定位,以减少对肾动脉的影响.记录气囊反搏前后患者血压,心率,血氧饱和度,中心静脉压,心脏指数,肾功能.结果:主动脉气囊反搏植入术后,患者平均动脉压,心率血氧饱和度,中心静脉压,心脏指数均有明显改善(P＜0.05).14例在IABP及升压药物维持血压稳定后行经皮冠状动脉成形术(PTCA)及支架植入,12例患者支架植入术后24～72小时成功撤除IABP.结论:床旁超声定位方法有以下优点:①节省时间,无放射线;②定位准确,有效避免反搏气囊对肾动脉血流的影响;③床旁IABP植入安全易行,迅速为患者提供可靠的循环支持;④为PTCA支架术提供保障.

INTRA-AORTIC BALLOON PUMP IMPLANTATION GUIDED BY ECHOCARDIOGRAPHY AT BEDSIDE TO SALVAGE PATIENTS WITH CARDIOGENIC SHOCK

Objective:To observe the feasibility and efficiency of intra-aortic balloon pump(IABP) implantation,guided by Echocardiographly in patients with cardiogenic shock.Methods:Seventeen patients with cardiogenic shock were treated by IABP supports. The implanting procedure was guided by Echocardiography at bedside. The systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate,CI,morbidity of organ dysfunction were compared.Results:The SBP,DBP and heart rate, morbidity of organ dysfunction in those patients after IABP were more significantly improved than those before IABP. Fourteen patients were performed PTCA and stenting after IABP support,and twelve patients finished IABP successfully within 24~72 hours after coronary stenting.Conclusion:The procedure of IABP implanting guided by Echocardiography at the bedside is convenient and reliable ,which can improve survival rate and reduce complications in patients with cardiogenic shock?