摘要
目的：探讨主动脉球囊反搏术（IABP）在经皮冠状动脉介入治疗（PCI）术后慢血流和无复流中应用的临床疗效和意义,为其临床治疗提供依据和新思路。方法：选取2013年11月-2014年10月74例行急诊PCI术治疗后出现慢血流和无复流的急性心肌梗死患者为研究对象,根据患者接受使用IABP与否分为两组,39例使用IABP患者为观察组,35例未使用IABP患者为对照组,随访3个月,分别对两组患者的左房内径、左室内径、左室射血分数、血流动力学稳定至PCI时间,治疗成功率、死亡率和并发症进行统计分析。结果：治疗后,两组血流动力学指标和尿量均较治疗前改善,治疗前后差异有统计学意义（P〈0.05）,观察组心率（82.4±7.8）次/min,收缩压（93.6±17.5）mmHg,舒张压（61.5±11.2）mmHg,尿量（42.4±7.6）mL/h,改善程度明显优于对照组,两组改善程度差异均有统计学意义（P〈0.05）;观察组稳定至PCI时间和住院时间均明显短于对照组,观察组左室射血分数术后1周及术后3个月均高于对照组,观察组1周和3个月后左房内径、左室内径均低于对照组,组间比较差异有统计学意义（P〈0.05）;两组手术成功率分别为87.18%、74.29%,观察组高于对照组,差异有统计学意义（P〈0.05）;在死亡率、并发症、心绞痛、再次心梗及再入院等发生率方面,观察组均低于对照组,差异有统计学意义（P〈0.05）。结论：主动脉球囊反搏术对经皮冠状动脉介入治疗术后慢血流和无复流的改善具有一定作用,值得在临床推广应用。
Objective： To investigate the effect of intra-aortic balloon counterpulsation （IABP） on slow blood flow and no reflow after percutaneous coronary intervention （PCI）. Methods： A total of 74 cases with acute myocardial infarction admitted from November 2013-October 2014 were selected. According to the use of IABP therapy, they were randomly divided into two groups, 39 cases in the observation group and 35 cases of IABP in control group. They were followed up for 3 months, respectively. Left atrial diameter, Ieft ventricular diameter, left ventricular ejection fraction, hemodynamic stabilization time, treatment success rate, mortality and complications were analyzed. Results： After treatment, hemodynamic indexes and urine volume were significantly improved in two groups （P〈0.05）. The improvement in heart rate, systolic blood pressure, diastolic blood pressure, urine volume were more significant than that of the control group （P〈0.05）. Stabilization time and hospital stay of observation group were significantly shorter than these of control group; left ventricular ejection fraction of observation group was significantly higher after one week and after S months （P〈0.05） ; left atrial diameter and left ventricular diameter of observation group were significantly lower （P〈0.05）. Success rates of two groups were 87.18%, 74.29% , respectively, significantly higher in the observation group （P〈0.05）. Mortality, incidence of complications and angina, recurrence of myocardial infarction and the incidence of readmission of the observation group were significantly lower than these of control group （P〈0.05）. Conclusions： IABP can improve blood flow and no-reflow in patients after PCI treatment, and it isworthy of clinical application.
出处
《海南医学院学报》
CAS
2015年第7期939-941,共3页
Journal of Hainan Medical University
基金
广东省卫生厅资助基金项目(2918223)~~
