摘要
目的探讨冠状动脉旁路移植术(coronary artery bypass grafting,CABG)围术期不同时间应用主动脉内球囊反搏(intra-aortic balloon pump,IABP)的效果。方法行CABG治疗冠心病患者65例,依据置入IABP时机分为术前组6例,术中组20例及术后组39例,比较3组围术期临床指标和血流动力学指标的差异。结论术前组病死率(0)低于术中组(30.0%)和术后组(38.5%)(P<0.05),术中组与术后组比较差异无统计学意义(P>0.05);术后组住院时间[(32.3±9.1)d]、ICU停留时间[(8.6±3.2)d]、机械通气时间[(78.3±32.1)h]和使用IABP时间[(112.0±38.2)h]明显高于术前组[(23.2±9.6)d、(5.1±1.5)d、(42.2±18.2)h、(80.2±21.2)h]和术中组[(25.3±8.6)d、(6.2±2.8)d、(48.3±21.3)h、(89.2±32.8)h](P<0.05);术前组与术中组比较差异无统计学意义(P>0.05);与置入IABP前相比,置入IABP后8h及撤除IABP前,3组血流动力学指标均明显改善,血管活性药物用量明显减少(P<0.05)。结论对行CABG的冠心病患者,术前置入IABP较术中及术后置入IABP有明显优势,可降低病死率。
Objective To evaluate the effect of intra-aortic balloon pump （IABP） at perioperative different time on coronary artery bypass grafting （CABG）F. Methods Sixty-five patients undergoing CABG were randomly divided into three groups, pre-operative group （n= 6）, intra-operative group （n= 20） and post∽operative group （n= 39） according to the timing of IABP insertion. The hemodynamic changes and clinical parameters were analyzed and compared among three groups. Results The fatality was significantly lower in pre-operative group （0） than that in intra-operative group （30.0 %） and post-operative group （38.5% ） （P〈0.05）, showing no significant difference between intra-operative group and post operative group （P〉0.05）. The hospitalization stay （（32.3±9.1） d）, ICU stay （（8.6±3.2） d）, mechanical ventilation time （（78.3±32.1） h） and IABP time （（112.0±38.2） h） were significantly longer in post-operative group than those in pre-operative group （（23.2±9.6） d, （5.1±1.5） d, （42.2±18.2） h, （80.2±21.2） h） and intra-operative group （（25.3±8.6） d, （6.2±2.8） d, （48.3±21.3） h, （89.2±32.8） h） （P〈0.05）, and there were no significant differences between pre-operative group and intra-operative group （P〉0.05）. The homodynamic indexes were improved and the dose of cardiovascular drugs decreased significantly in all three groups 8 hours after IABP and before the withdrawal of IABP （P〈0.05）. Conclusion Pre-operative use of IABP is surperior to intra-operative and post operative use of IABP, and can decrease the fatality of coronary heart disease patients undergoing CABG.
出处
《中华实用诊断与治疗杂志》
2015年第8期806-808,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
冠心病
主动脉内球囊反搏
冠状动脉旁路移植术
围手术期
Coronary heart disease
intra aortic balloon pumping
coronary artery bypass grafting
perioperative period
