论文部分内容阅读
目的:探讨主动脉内球囊反搏(IABP)支持下急诊经皮冠状动脉介入(PCI)治疗急性心肌梗死(AMI)并心源性休克(CS)的临床疗效。方法:选取急诊PCI治疗的AMI并CS的患者47例,24例接受IABP支持下急诊PCI治疗的患者为治疗组,23例直接急诊PCI治疗的患者为对照组。治疗一周后,检测两组患者平均动脉压(MAP)、尿量、心率、肺动脉楔压(PCWP)、心脏指数(CI)、左室射血分数(LVEF)、及N末端血浆B型尿钠肽前体(NT-pro BNP)指标的变化,多巴胺、速尿和硝酸酯类用量的比较及死亡率比较。结果:治疗前两组各项观察指标差异无统计学意义(P>0.05);治疗后两组各项观察指标与治疗前比较,差异均有统计学意义(P<0.05);治疗后两组各观察指标差值比较,差异有统计学意义(P<0.05);治疗组多巴胺、速尿用量少于对照组,差异有统计学意义(P<0.05);治疗组硝酸酯类用量少于对照组,但差异无统计学意义(P>0.05);治疗后两组死亡率比较,差异有统计学意义(P<0.05)。结论:急性心肌梗死并心源性休克患者在IABP支持下行急诊PCI,可明显改善患者的冠状动脉血流,改善心肌的血供,改善心功能,降低病死率。
Objective: To investigate the clinical effect of emergency percutaneous coronary intervention (PCI) on acute myocardial infarction (AMI) and cardiogenic shock (CS) supported by intra-aortic balloon pump (IABP). Methods: Forty-seven patients with AMI and CS undergoing emergency PCI were enrolled. Twenty-four patients undergoing PCI with IABP support were treated with PCI, and 23 patients with PCI treated by direct emergency PCI as control group. After a week of treatment, mean arterial pressure (MAP), urine output, heart rate, pulmonary artery wedge pressure (PCWP), cardiac index (CI), left ventricular ejection fraction (LVEF), and N-terminal plasma B-type natriuretic peptide Changes of NT-pro BNP index, comparison of dopamine, furosemide and nitrates dosage and mortality comparison. Results: There was no significant difference between the two groups before treatment (P> 0.05). After treatment, there were significant differences between the two groups in observation indexes and before treatment (P <0.05) The differences between the observation indexes were statistically significant (P <0.05). The dosage of dopamine and furosemide in the treatment group was less than that of the control group (P <0.05), and the dosage of nitrates in the treatment group was less In the control group, but the difference was not statistically significant (P> 0.05). There was significant difference in the mortality rate between the two groups after treatment (P <0.05). Conclusions: Emergency PCI in patients with acute myocardial infarction and cardiogenic shock supported by IABP can significantly improve coronary blood flow, improve myocardial blood supply, improve cardiac function and reduce mortality.