摘要
目的观察联合应用血管再通、主动脉内球囊反搏(IABP)和机械通气治疗急性心肌梗死(AMI)并发心源性休克(CGS)、呼吸衰竭(RF)的疗效。方法 40例AMI并发CGS和RF患者分为2组,观察组20例采用血管再通、床旁IABP联合机械通气治疗,对照组20例采用床旁IABP联合机械通气治疗,观察比较2组患者的治疗效果。结果治疗前2组患者平均动脉压(MAP)、尿量、动脉血氧分压(PaO2)、心脏指数(CI)及多巴胺使用量比较差异均无统计学意义(P>0.05);治疗后2组患者MAP、尿量、PaO2、CI及多巴胺使用量较治疗前均显著改善(P<0.05);治疗后2组患者MAP、尿量、PaO2及多巴胺使用量比较差异均无统计学意义(P>0.05),但观察组患者CI显著高于对照组(P<0.05)。2组患者机械通气时间和IABP时间比较差异均无统计学意义(P>0.05);观察组患者住重症监护病房时间和住院时间均显著短于对照组(P<0.05),观察组患者病死率显著低于对照组(P<0.01)。结论血管再通联合IABP、机械通气可有效改善AMI并发CGS和RF患者的心脏指数,缩短住院时间,降低病死率。
Objective To observe the effect of revascularization combined with intra-aortic balloon pump（IABP） and mechanical ventilation on patients with acute myocardial infarction（AMI） complicated with cardiogenic shock（CGS） and respiratory failure（RF）.Methods Forty patients with AMI complicated with CGS and RF were divided into two groups,twenty cases in each group.The patients in observation group were treated with revascularization,IABP and mechanical ventilation,while the patients in control group were treated with IABP and mechanical ventilation.The therapeutic effect was observed and compared between the two groups.Results Before treatment,there was no statistically significant difference in mean arterial pressure（MAP）,urine volume,partial pressure of oxygen in artery（PaO2）,cardiac index（CI） and dopamine dosage between the two groups（P0.05）.MAP,urine volume,PaO2,CI and dopamine dosage improved significantly after treatment in both group（P0.05）.After treatment,there was no statistically significant difference in MAP,urine volume,PaO2 and dopamine dosage between the two groups（P0.05）,but the CI was significantly higher in observation group（P0.05）.There was no statistically significant difference in mechanical ventilation time and IABP time between the two groups（P0.05）,but the time of in intensive care unit and hospitalization time in observation group were shorter than those in control group（P0.05）,and the case fatality in observation group was lower than that in control group（P0.01）.Conclusion The treatment of revascularization combined with IABP and mechanical ventilation on patients with AMI complicated with CGS and RF can effectively improve CI,shorten hospitalization time and degrade the case fatality.
出处
《新乡医学院学报》
CAS
2012年第12期925-927,930,共4页
Journal of Xinxiang Medical University
关键词
急性心肌梗死
心源性休克
血管再通
主动脉内球囊反搏
机械通气
acute myocardial infarction
cardiogenic shock
vascular revascularization
intra-aortic balloon counterpulsation
mechanical ventilation
