摘要
目的:探讨主动脉球囊反搏对非体外冠状动脉旁路移植术后发生急性左心衰竭患者呼吸循环状态及心功能的影响。方法:回顾性分析某院收治的行非体外冠状动脉旁路移植术后发生急性左心衰竭的90例患者的临床资料,按照治疗方法的不同将其分为观察组和对照组,其中对照组45例,给予无创正压通气治疗,观察组45例,给予无创正压通气联合主动脉球囊反搏治疗,比较2组患者呼吸循环状态及心功能改善情况。结果:2组患者的呼吸频率、心率明显减慢,动脉血氧分压、平均动脉压、血液脑钠肽指标显著上升,LVEF明显下降,与治疗前比较差异显著,观察组上述指标变化幅度更大,2组比较差异有统计学意义(P<0.05或P<0.01);观察组术后二次气管插管、气管切开、多器官功能衰竭发生率均明显低于对照组,组间比较差异有统计学意义(P<0.05)。结论:对于非体外冠状动脉旁路移植术后发生急性左心衰竭患者,主动脉球囊反搏辅助无创正压通气治疗可显著缓解患者的呼吸循环衰竭,有效改善其心功能,对提高抢救效果有积极意义。
Objective：To investigate the effects of intra-aortic balloon pump （IABP） on respiratory circulatory status and cardiac function in patients with acute left heart failure after off-pump coronary artery bypass grafting. Methods ： Clinical data of 90 patients with acute left heart failure were analyzed retrospectively in a hospital, who were treated by non-extracorporeal coronary artery bypass graft- ing. The patients were divided into an observation group and a control group,45 cases in each. The control group was given noninvasive positive pressure ventilation treatment, while the observation group underwent noninvasive positive pressure ventilation combined with IABP. The respiratory circulation status and cardiac function improvement of the two groups were compared. Results： The respiratory rate and heart rate of the two groups significantly decreased, while the arterial blood oxygen partial pressure, average arterial pressure and blood brain natriuretic peptide index increased significantly. LVEF decreased, significantly different from before the treatment. More changes of the above indexes occurred in the observation group. The difference between the two groups was statistically significant { P 〈0. 05 or P 〈0.01）. The incidence of secondary endotracheal intubation, tracheotomy, and multiple organ failure in the observation group were significantly lower than those in the control group, the difference being significant （ P 〈 0.05 ）. Conclusion： For patients with acute left heart failure after coronary artery bypass grafting, IABP assisted noninvasive positive pressure ventilation treatment can significantly alleviate the patient＇s respiratory and circulatory failure and effectively improve its cardiac function, which has a positive meaning for promoting the effectiveness of the rescue.
出处
《淮海医药》
CAS
2018年第2期153-155,共3页
Journal of Huaihai Medicine
关键词
急性左心衰竭
主动脉球囊反搏
心脏功能
Acute left heart failure
intra-aortic balloon pump
Heart function
