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目的探讨尽早置入主动脉内球囊反搏(IABP)救治的高危急性前壁心肌梗死患者的可行性及安全性,以及对于近期预后的影响。方法选取2002年1月至2007年1月广东省梅州市人民医院心内科收治的高危急性前壁心肌梗死患者共57例,随机分为IABP组(n=26)及对照组(n=31),并行急诊PCI治疗,比较再灌注后出现低血压情况、心肌梗死溶栓试验(TIMI)血流、手术时间、术中血压、尿量两组间均在统计学存在显著差异以及两组住院期间疗效及并发症。结果两组间血管情况无统计学差异;再灌注低血压、心肌梗死溶栓试验(TIMI)血流、手术时间、症状缓解时间、术中血压、尿量两组间均在统计学存在显著差异。两组均无死亡病例。严重并发症IABP组2例,对照组4例;在多巴胺使用时间、加用冠心病二级预防用药β受体阻滞剂和血管转换酶抑制剂(ACEI)或血管转换酶受体抑制剂(ARB)的时间、住院天数等两组间比较有显著性差异。I-ABP组中出现两例局部并发症。结论IABP早期用于高危急性前壁心肌梗死患者是可行的并是安全的,对于近期预后是有利的。
Objective To investigate the feasibility and safety of high-risk acute anterior myocardial infarction (AMI) treated by intra-aortic balloon pump (IABP) as early as possible and its effect on the short-term prognosis. Methods A total of 57 high-risk acute anterior myocardial infarction patients admitted to Department of Cardiology, Meizhou People’s Hospital of Guangdong Province from January 2002 to January 2007 were randomly divided into IABP group (n = 26) and control group (n = 31) , Concurrent emergency PCI, comparing the occurrence of hypotension after reperfusion, myocardial infarction thrombolysis test (TIMI) blood flow, operation time, intraoperative blood pressure, urine output were statistically significant differences between the two groups and the two groups during hospitalization Efficacy and complications. Results There was no significant difference in blood vessels between the two groups; there was a significant difference between the two groups in reperfusion hypotension, myocardial infarction thrombolysis (TIMI) blood flow, operation time, symptom relief time, intraoperative blood pressure and urine output . No deaths were reported in both groups. Serious complications of IABP group 2 cases, 4 cases of control group; in dopamine use time, plus secondary prevention of coronary heart disease with β-blockers and angiotensin converting enzyme inhibitors (ACEI) or angiotensin converting enzyme inhibitor ARB), hospitalization days and other groups were significantly different. Two cases of local complications occurred in the I-ABP group. Conclusions Early use of IABP in high-risk patients with acute anterior myocardial infarction is feasible and safe, and is beneficial for the near future prognosis.