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目的:评价预防性置入主动脉球囊反搏(IABP)和被动紧急置入主动脉球囊反搏在高危急性心肌梗死(AMI)PCI患者中应用的效果。方法:A组25例为入院时行急诊PCI术治疗前预防性置入IABP;而B组23例为术中或术后血流动力学不稳定、心功能不全、低心排综合征等接受IABP紧急置入。分析A、B两组术后临床效果,比较两组术后病死率、并发症发生率、术后心血管活性药物应用、IABP使用时间。结果:A组术后病死率和并发症发生率为8.0%和0%,B组为47.8%和0%;术后平均正性肌力药物辅助时间分别为(52.6±15.7)h与(89.8±12.7)h,P<0.05;平均IABP使用时间分别为(44.6±17.4)h与(87.1±22.2)h,P<0.05。结论:对于高危冠状动脉PCI患者,术前预防性置入IABP能减少正性肌力药物辅助时间,缩短IABP辅助时间,降低术后病死率。
Objective: To evaluate the effect of prophylactic aortic balloon pump (IABP) and passive emergency aortic balloon counterpulsation in patients with high-risk acute myocardial infarction (AMI) PCI. Methods: Twenty-five patients in group A received prophylactic IABP before admission undergoing emergency PCI. Group B received intraoperative or postoperative hemodynamic instability, cardiac insufficiency, and low cardiac output syndrome IABP emergency placement. The clinical effects of A and B groups were analyzed. The postoperative mortality, the incidence of complications, the application of postoperative cardiovascular drugs and IABP duration were compared between the two groups. Results: The postoperative morbidity and complications of group A were 8.0% and 0%, while those of group B were 47.8% and 0% respectively. The mean duration of postoperative inphaotropic time was (52.6 ± 15.7) h and (89.8) ± 12.7) h, P <0.05; mean IABP use time was (44.6 ± 17.4) h and (87.1 ± 22.2) h, respectively, P <0.05. CONCLUSIONS: Preoperative prophylactic IABP reduces the duration of inotropic agents, shortens the IABP adjuvant time and decreases postoperative mortality in high-risk PCI patients.