摘要
目的总结主动脉内球囊反博辅助非体外循环冠状动脉搭桥手术治疗重症冠心病的临床经验。方法回顾性分析2011年1月—2012年10月该院心脏外科行主动脉内球囊反搏(IABP)辅助完成非体外循环冠状动脉搭桥手术治疗32例重症冠心病患者临床资料。结果全组32例手术患者,术前心脏手术风险评估欧洲系统评分EuroScore(6.5±2.3)分,其中>6分者23例(71.9%)。麻醉诱导后置入IABP 26例(81.2%),术中置入IABP 6例(18.8%),搭桥数目3支者14例(43.8%),4支者17例(53.1%),5支者1例(3.1%),术后呼吸支持时间16(12,19)h,ICU住院时间(76±46)h。术后发生并发症包括呼吸道感染3例(9.4%),急性肾功能不全2例(6.3%),切口愈合不良5例(15.6%)。全组患者均治愈出院。结论重症冠心病患者围手术期置入IABP可以明显获益。患者有IABP应用指征时,应果断尽早应用。
Objective To investigate the efficacy of intra-aotic balloon pump（IABP） in off-pump coronary artery bypass graft patients with severe coronary heart disease.Methods 32 severe coronary artery disease patients from the Dept of Cardiac Surgery of the First Affiliated Hospital of Anhui Medical University between January 2011 to October 2012,aided by IABP,underwent off-pump coronary artery bypass surgery.Results In the group,32 patients accepted IABP therapy,26 cases with preoperative IABP insertion（81.2%）,6 for intra-operative IABP insertion（18.8%）.We assessed the operative risk preoperatively with EuroSCORE,average（6.5 ± 2.3）,23 cases（71.9%） 6.Fourteen patients fixed up 3 grafts（43.8%）,17 cases with 4 grafts（53.1%）,1 case with 5 grafts（3.1%）.Ventilator supporting time was 16（12,19） h.ICU stay was（76 ± 46） h.Complications included respiratory tract infection 3 cases,acute renal insufficiency 2 cases,and five cases poor healing.OPCABG was successful in all patients.Conclusion Compared with intra-or post-operative IABP insertion,high-risk patients undergoing CABG can significantly benefit from IABP insertion in perioperative period.Early IABP insertion should be recommended for high-risk patients undergoing coronary artery bypass grafting.
出处
《安徽医药》
CAS
2013年第8期1333-1335,共3页
Anhui Medical and Pharmaceutical Journal
