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目的探讨主动脉内球囊反搏在救治高危心肌梗死中的作用。方法对25例急性心肌梗死患者入院时、溶栓治疗后、经皮冠状动脉腔内成形术(PTCA)和冠状动脉旁路移植术(CABG)前出现血液动力学不稳或心源性休克者行主动脉内囊反搏辅助治疗。结果25例患者中17例(68%)在IABP使用5~118 h(平均20 h)后血流动力学平稳;8例死亡,死因包括心源性休克(6例),心脏破裂(1例),恶性心律失常(2例),无因IABP引起的并发症而导致死亡,3例行IABP患者穿刺部位肿胀,局部形成血肿。结论IABP能降低AM I患者的临床事件发生率和死亡率,能有效减轻心衰,改善心功能,为进一步治疗争取到足够的时间,但对术中急性血管病变作用有限。
Objective To investigate the role of intra-aortic balloon pump in the treatment of high-risk myocardial infarction. Methods Twenty-five patients with acute myocardial infarction were admitted to hospital. Thrombolytic therapy followed by unstable hemodynamics or cardiogenic shock before percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) Line Aortic Encapsulation Counter-adjuvant therapy. Results Seventeen (68%) of the 25 patients had stable hemodynamics after 5 to 118 h (average 20 h) of IABP. Eight patients died of cardiogenic shock (6) and heart rupture (1 patient ), And malignant arrhythmias (2 cases). No deaths were caused by the complications caused by IABP. The puncture site of 3 patients with IABP was swollen and the hematoma formed locally. Conclusions IABP can reduce the incidence of clinical events and mortality in patients with AMI. It can effectively reduce heart failure, improve cardiac function, obtain sufficient time for further treatment, but it has limited effect on acute intravascular angiopathy.