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目的评价主动脉内球囊反搏术在高危冠心病患者介入治疗中的应用价值。方法自2001年11 月至2003年9月,共有119例患者接受冠状动脉介入治疗,其中有4例冠心病介入治疗的高危患者在介入治疗前或介入治疗后应用主动脉内球囊反搏术辅助装置。男性2例,女性2例,年龄53-70岁。结果 1例为顽固性心绞痛合并心功能不全,1例为顽固性心绞痛,2例为急性心肌梗死合并心源性休克或心功能不全。2例顽固性心绞痛患者在介入治疗前48小时置入主动脉内球囊反搏术,介入治疗后即刻或4小时后拔除主动脉内球囊反搏装置。另2例急性心肌梗死患者在介入治疗后24-72小时拔除主动脉内球囊反搏装置。4例患者随访至今一般情况良好,无再发心绞痛或心肌梗死。结论对冠心病介入治疗高危患者,如左主干病变、复杂病变、急性心肌梗死合并心原性休克或心功能不全患者,主动脉内球囊反搏术可明显改善临床症状,降低介入治疗的风险。
Objective To evaluate the value of intra-aortic balloon pump in the interventional treatment of high-risk patients with coronary heart disease. METHODS: From November 2001 to September 2003, a total of 119 patients undergoing coronary intervention were enrolled. Among them, 4 of the high-risk patients with coronary intervention were treated with intra-aortic balloon pump before intervention or after intervention assisting equipments. 2 males and 2 females, aged 53-70 years old. Results One patient had refractory angina with cardiac insufficiency, one patient with refractory angina and two patients with acute myocardial infarction with cardiogenic shock or cardiac insufficiency. Two patients with refractory angina pectoris were treated with intra-aortic balloon catheterization 48 hours before interventional therapy, and intra-aortic balloon pump was removed immediately or 4 hours after interventional therapy. The other 2 patients with acute myocardial infarction were removed intra-aortic balloon pump 24-72 hours after interventional therapy. Four patients were followed up so far generally good, no recurrence of angina or myocardial infarction. Conclusion Intra-aortic balloon pump can significantly improve clinical symptoms and reduce the risk of interventional therapy in high-risk patients with coronary heart disease such as left main disease, complicated lesions, acute myocardial infarction complicated with cardiogenic shock or cardiac insufficiency .