主动脉球囊反搏辅助治疗高危老年急性心肌梗死的临床研究(1)
摘要：目的 探讨主动脉球囊反搏(IABP)在老年急性心肌梗死(AMI)并心源性休克(CS)患者治疗中安全性及有效性。方法 回顾性分析收集我院心内科2010年10月～2016年3月行冠状动脉介入治疗年龄大于65岁的老年急性心肌梗死合并心源性休克的患者为研究对象。分为置入IABP组为试验组及未置入IABP组为对照组。比较实验组患者使用IABP前后血流动力学各项指标及心功能的变化；比较两组患者多巴胺使用时间、休克纠正时间、在ICU治疗时间、血乳酸水平、30 d死亡率。结果 实验组在使用IABP后血流动力学各项指标及心功能较使用前有显著改善(P<0.05或P<0.01)；两组患者多巴胺使用时间、休克纠正时间、在ICU治疗时间、血乳酸对比，差异有统计学意义(P<0.05)；IABP组30 d死亡率较对照组明显降低(P<0.05)。结论 在老年急性心肌梗死并心源性休克的患者中使用IABP，能迅速稳定血流动力学及改善心功能。缩短患者治疗时间及稳定内环境，降低死亡率。IABP安全性及有效性高，值得临床推广。
关键词：主动脉球囊反搏；心源性休克；急性心肌梗死
, http://www.100md.com
Abstract：Objective To investigate the safety and efficacy of intra-aortic balloon pump (IABP) in the treatment of acute myocardial infarction (AMI) in elderly patients with acute myocardial infarction (AMI). Methods Retrospective analysis of our hospital in March October 2010 ～2016 year in admitted to the treatment of coronary artery intervention in elderly patients aged over 65 years old with acute myocardial infarction complicated with cardiac shock patients as the research object.The IABP group was divided into the experimental group and the control group without IABP group.The changes of hemodynamic indexes and cardiac function before and after IABP were compared between the experimental group and the experimental group.Compared the two groups of patients with dopamine use time， shock correction time， the treatment time in ICU， blood lactate level， 30d mortality.Results In the experimental group， there was a significant improvement in the hemodynamic indexes and cardiac function after IABP(P<0.05 or P<0.01).Two groups of patients with dopamine use time， shock correction time， treatment time in ICU， blood lactic acid contrast， the difference was statistically significant(P<0.05).The mortality of 30d in group IABP was significantly lower than that in control group(P<0.05).Conculsion IABP is used in elderly patients with acute myocardial infarction and cardiac shock， which can rapidly stabilize hemodynamics and improve cardiac function.Shorten the treatment time and stable internal environment， reduce the mortality rate.IABP is safe and effective， it is worth of clinical promotion.
, 百拇医药
Key words：Intraaortic balloon pump； Acute myocardial infarction； Cardiac shock
老年患者的急性心肌梗死(acute myocardialinfarction，AMI)往往侵犯多支血管，梗死面積大，心脏泵功能常明显受损，易并发心源性休克(cardiogenic shock，CS)。对于AMI并CS的患者血运重建是最有效的治疗方法但死亡率仍高。主动脉球囊反搏术(intra-aortic balloon pump，IABP)通过在主动脉内置入反搏球囊，增加舒张期冠脉灌注，减轻左心室后负荷，达到降低心肌做功、减少心肌氧耗量的目的，可改善血流动力学及左心功能[1]。但近年来的几项研究对IABP在AMI并CS患者行冠状动脉介入治疗中的作用尚存在争议[2-3]。基于IABP疗效的不同说法，本次研究就IABP对心肌梗死合并心源性休克患者的有效性、安全性与预后进行探讨。, http://www.100md.com(杨志敏 李显刚 颜涛)
关键词：主动脉球囊反搏；心源性休克；急性心肌梗死
, http://www.100md.com
Abstract：Objective To investigate the safety and efficacy of intra-aortic balloon pump (IABP) in the treatment of acute myocardial infarction (AMI) in elderly patients with acute myocardial infarction (AMI). Methods Retrospective analysis of our hospital in March October 2010 ～2016 year in admitted to the treatment of coronary artery intervention in elderly patients aged over 65 years old with acute myocardial infarction complicated with cardiac shock patients as the research object.The IABP group was divided into the experimental group and the control group without IABP group.The changes of hemodynamic indexes and cardiac function before and after IABP were compared between the experimental group and the experimental group.Compared the two groups of patients with dopamine use time， shock correction time， the treatment time in ICU， blood lactate level， 30d mortality.Results In the experimental group， there was a significant improvement in the hemodynamic indexes and cardiac function after IABP(P<0.05 or P<0.01).Two groups of patients with dopamine use time， shock correction time， treatment time in ICU， blood lactic acid contrast， the difference was statistically significant(P<0.05).The mortality of 30d in group IABP was significantly lower than that in control group(P<0.05).Conculsion IABP is used in elderly patients with acute myocardial infarction and cardiac shock， which can rapidly stabilize hemodynamics and improve cardiac function.Shorten the treatment time and stable internal environment， reduce the mortality rate.IABP is safe and effective， it is worth of clinical promotion.
, 百拇医药
Key words：Intraaortic balloon pump； Acute myocardial infarction； Cardiac shock
老年患者的急性心肌梗死(acute myocardialinfarction，AMI)往往侵犯多支血管，梗死面積大，心脏泵功能常明显受损，易并发心源性休克(cardiogenic shock，CS)。对于AMI并CS的患者血运重建是最有效的治疗方法但死亡率仍高。主动脉球囊反搏术(intra-aortic balloon pump，IABP)通过在主动脉内置入反搏球囊，增加舒张期冠脉灌注，减轻左心室后负荷，达到降低心肌做功、减少心肌氧耗量的目的，可改善血流动力学及左心功能[1]。但近年来的几项研究对IABP在AMI并CS患者行冠状动脉介入治疗中的作用尚存在争议[2-3]。基于IABP疗效的不同说法，本次研究就IABP对心肌梗死合并心源性休克患者的有效性、安全性与预后进行探讨。, http://www.100md.com(杨志敏 李显刚 颜涛)
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