摘要
目的探讨主动脉内球囊反搏（IABP）在高危冠状动脉旁路移植术（CABG）围术期预防性应用的效果。方法41例高危cABG病人围术期应用IABP辅助，其中20例为预防性应用（Y组），21例为CABG围术期发生严重低心排被迫应用（B组）。术前两组性别、年龄、体表面积、心功能、射血分数、病变程度基本一致，仅冠心病合并室壁瘤情况，Y组显著高于B组（70％对38．1％P=0．04）。结果Y组与B组生存率为95．0％对85．7％（P=0．31），IABP应用时间为（72．5±28．91）h对（97．47±47．70）h，（P=0．02），术中严重低血压或心律失常发生率5％对66．7％（P〈0．0001）。术后呼吸机应用时间（22．0±1．6）h对（39．6±2．1）h（P=0．005）、ICU停留时间（58．0±1．5）h对（98．5±1．9）h（P=0．003）。结论IABP的预防性应用为高危CABG病人提供了安全保障，术中严重低血压或心律失常发生率低，病情恢复快。
Objective To determine the importance of preventive use of intranortie balloon pump （IABP） in high-risk patients underwent coronary artery bypass grafting （CABG） surgery. Methods 41 high-risk CABG patients were divided into two groups determined by the time of IABP onset. 21 patients （control group, CG） were with cardiac event occurred, 20 patients （pre-use group, PG） were preventive use of IABP. The eharacterastics of the two groups were no significant different except the percentage of ventricular anemysm （70% in PG versus 38.1% in CG, P=0.04）. Results More patients in PG survived than thosein CG （95.0% versus 85.7 %, P = 0.31 ）. Significantly prolonged duration of IABP in CG was explored （ 72.5 ± 28.91 ） hours in PG versus （ 97.47 ± 47.70） hours in CG, P =0.02. The hypotension or arhythmia were significant lower in PG during operation （5% in PG versus 66.7% in CG, P 〈 0.0001）. The patients in PG had significantly short ventilator support time [ （22.0 ± 1.6） hours versus （39.6 ± 2.1） hours, P=0.005] and intensive care unit （ICU） stay [（58.0±1.5） hours versus （98.5± 1.9） hours, P=0.003]. Conclusion Preventive use of IABP in high-risk patients underwent CABG can support safety. It may reduce hypotension or arhythmia during operation.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2009年第1期20-22,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
冠状动脉分流术
手术期间
主动脉内气囊泵
手术后并发症
Coronary artery bypass Intraoperoctive period Intra-aortic balloon pumping Postoperative complications
