中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2009年
1期
20-22
,共3页
高泉鑫%龚庆成%李嘉维%刘岸新%孙志全%赵岩岩%缪娜%邢家林%贾在申%陈彧%刘晓军
高泉鑫%龔慶成%李嘉維%劉岸新%孫誌全%趙巖巖%繆娜%邢傢林%賈在申%陳彧%劉曉軍
고천흠%공경성%리가유%류안신%손지전%조암암%무나%형가림%가재신%진욱%류효군
冠状动脉分流术%手术期间%主动脉内气囊泵%手术后并发症
冠狀動脈分流術%手術期間%主動脈內氣囊泵%手術後併髮癥
관상동맥분류술%수술기간%주동맥내기낭빙%수술후병발증
Coronary artery bypass%Intraoperoctive period%Intra-aortic balloon pumping%Postoperative complications
目的 探讨主动脉内球囊反搏(LABP)在高危冠状动脉旁路移植术(CABG)围术期预防性应用的效果.方法 41例高危CABG病人围术期应用IABP辅助,其中20例为预防性应用(Y组),21例为CABG围术期发生严重低心排被迫应用(B组).术前两组性别、年龄、体表面积、心功能、射血分数、病变程度基本一致,仅冠心病合并室壁瘤情况,Y组显著高于B组(70%对38.1%P=0.04).结果 Y组与B组生存率为95.0%对85.7%(P=0.31),IABP应用时间为(72.5±28.91)h对(97.47±47.70)h,(P=0.02),术中严重低血压或心律失常发生率5%对66.7%(P<0.0001).术后呼吸机应用时间(22.0±1.6)h对(39.6±2.1)h(P=0.0015)、ICU停留时间(58.0±1.5)h对(98.5±1.9)h(P=0.003).结论 IABP的预防性应用为高危CABG病人提供了安全保障,术中严重低血压或心律失常发生率低,病情恢复快.
目的 探討主動脈內毬囊反搏(LABP)在高危冠狀動脈徬路移植術(CABG)圍術期預防性應用的效果.方法 41例高危CABG病人圍術期應用IABP輔助,其中20例為預防性應用(Y組),21例為CABG圍術期髮生嚴重低心排被迫應用(B組).術前兩組性彆、年齡、體錶麵積、心功能、射血分數、病變程度基本一緻,僅冠心病閤併室壁瘤情況,Y組顯著高于B組(70%對38.1%P=0.04).結果 Y組與B組生存率為95.0%對85.7%(P=0.31),IABP應用時間為(72.5±28.91)h對(97.47±47.70)h,(P=0.02),術中嚴重低血壓或心律失常髮生率5%對66.7%(P<0.0001).術後呼吸機應用時間(22.0±1.6)h對(39.6±2.1)h(P=0.0015)、ICU停留時間(58.0±1.5)h對(98.5±1.9)h(P=0.003).結論 IABP的預防性應用為高危CABG病人提供瞭安全保障,術中嚴重低血壓或心律失常髮生率低,病情恢複快.
목적 탐토주동맥내구낭반박(LABP)재고위관상동맥방로이식술(CABG)위술기예방성응용적효과.방법 41례고위CABG병인위술기응용IABP보조,기중20례위예방성응용(Y조),21례위CABG위술기발생엄중저심배피박응용(B조).술전량조성별、년령、체표면적、심공능、사혈분수、병변정도기본일치,부관심병합병실벽류정황,Y조현저고우B조(70%대38.1%P=0.04).결과 Y조여B조생존솔위95.0%대85.7%(P=0.31),IABP응용시간위(72.5±28.91)h대(97.47±47.70)h,(P=0.02),술중엄중저혈압혹심률실상발생솔5%대66.7%(P<0.0001).술후호흡궤응용시간(22.0±1.6)h대(39.6±2.1)h(P=0.0015)、ICU정류시간(58.0±1.5)h대(98.5±1.9)h(P=0.003).결론 IABP적예방성응용위고위CABG병인제공료안전보장,술중엄중저혈압혹심률실상발생솔저,병정회복쾌.
Objective To determine the importance of preventive use of intraaortic balloon pump (IABP) in high-risk patients underwent cnronary artery bypass grafting (CABG) surgery. Methods 41 high-risk CABG patients were divided into two groups determined by the time of IABP onset. 21 patients (control group, CG) were with cardiac event occurred, 20 patients (pre-use group, PG) were preventive use of IABP. The characterastics of the two groups were no significant different except the percentage of ventricular aneurysm (70% in PC; versus 38.1% in CG, P = 0.04). Results More patients in PG survived than those in CG (95.0% versus 85.7 %, P = 0.31 ). Significantly prolonged duration of IABP in CG was explored (72.5 ± 28.91 ) hours in PG versus (97.47 ±47.70) hours in CG, P =0.02. The hypotension or arhythmia were significant lower in PG during operation (5% in PG versus 66.7 % in CG, P < 0.0001 ). The patients in PG had significantly short ventilator support time [(22.0 ± 1.6) hours versus (39.6 ±2.1) hours, P=0.005] and intensive care unit (ICU) stay [(58.0±1.5) hours versus (98.5±1.9) hours, P=0.003]. Conclusion Preventive use of IABP in high-risk patients underwent CABG can support safety. It may reduce hypotension or arhythmia during operation.
