主动脉内球囊反搏在急性心肌梗死合并泵衰竭急诊介入中的治疗疗效

目的探讨主动脉内球囊反搏(IABP)在急性心肌梗死(AMI)合并泵衰竭急诊介入中辅以治疗的安全性及有效性。方法对发病在24 h以内的38例AMI患者,在IABP支持下进行急诊冠状动脉造影,对梗死相关血管直接进行急诊经皮冠状动脉介入治疗术(PCI),术后第5周进行心脏超声检查及心功能测定。结果 4例在IABP术1h内因心衰及休克加重而死亡,34例梗死相关血管全部再通,发病至血管再通的平均时间为9.1 h,其中31例置入支架,PCI后5周内5例死亡,总死亡率为23.68%。29例存活患者在术后第5周检查左心室射血分由41%±5%升高为48%±7%。结论对于高危AMI合并泵衰竭在进行急诊PCI时,IABP的辅助使用明显降低死亡率,提高手术成功率,改善术后近期心功能。

Pump failure complicating acute myocardial infarction:the use of the intraaortic balloon pump support in emergency interventional procedures

Objective To observe the effect and safety of intraaortic balloon pump(IABP) support in the oincrgcncy interventional procedures on pump failure or cardiogenic shock complicating acute myocardial infarction acute myocardial infarction.Methods Emergency coronary artoriongraphy was taken 24 h after the attack,and percutaneous coronary intervention was performed on infarction related artery supported by IABP until patients complication improved.Myocardial echocardiography was taken 5 weeks after operation.Results Except for 4 patients who died of aggravated shock or cardiac failure,all the patients had infarction related artery reperfusion.34patients had stents implanted(91.2%).Mean time from attack to reperfusion was 9.1 h,and death rate in the period of 5 weeks was 23.68%.Left ventricular ejection fraction of the 29 patients who survived hoisted from 41%±5%to 48%±7%,the difference had significant statistic mcaning.Conclusion The combination of early IABP and successful emergency coronary intervention is clearly associated with improved survival and cardiac function in patients with pump failure orcardiogenic shock complicating acute myocardial infarction.