CAJ | 학술논문

目的：探讨主动脉球囊反搏（IABP）联合无创呼吸机对急性心肌梗死（AMI）并发泵衰竭行急诊经皮冠状动脉介入治疗（PCI）后患者的近期疗效及安全性。方法：选择2012年7月～2014年6月因AMI合并泵衰竭收住我院CCU患者105例，均行急诊 PCI术及药物等常规治疗，其中 IABP组68例（在常规治疗基础上联合应用IABP及无创呼吸机），常规治疗组37例（常规治疗及无创呼吸机）。观察住院期间两组患者的血压、心率、尿量、心脏彩超及BNP等指标变化以及有无并发症和心脏不良事件的发生。结果：与常规治疗组比较， IABP组患者住院期间血压明显升高，心率逐渐降低至稳定，左室射血分数[（35±9）％比（37±10）％]明显提高，BNP水平[（467±197） pmol/L比（236±146） pmol/L]、死亡率（28.9％比19.1％）显著下降，住院天数明显缩短[（16.2±4.1） d比（11.6±3.4） d]，P＜0.05～＜0.01。结论：主动脉球囊反搏联合无创呼吸机可显著改善急性心肌梗死合并泵衰竭患者的病情，稳定血流动力学状态，降低院内死亡率，为进一步的改善预后治疗赢得时间。
목적：탐토주동맥구낭반박（IABP）연합무창호흡궤대급성심기경사（AMI）병발빙쇠갈행급진경피관상동맥개입치료（PCI）후환자적근기료효급안전성。방법：선택2012년7월～2014년6월인AMI합병빙쇠갈수주아원CCU환자105례，균행급진 PCI술급약물등상규치료，기중 IABP조68례（재상규치료기출상연합응용IABP급무창호흡궤），상규치료조37례（상규치료급무창호흡궤）。관찰주원기간량조환자적혈압、심솔、뇨량、심장채초급BNP등지표변화이급유무병발증화심장불량사건적발생。결과：여상규치료조비교， IABP조환자주원기간혈압명현승고，심솔축점강저지은정，좌실사혈분수[（35±9）％비（37±10）％]명현제고，BNP수평[（467±197） pmol/L비（236±146） pmol/L]、사망솔（28.9％비19.1％）현저하강，주원천수명현축단[（16.2±4.1） d비（11.6±3.4） d]，P＜0.05～＜0.01。결론：주동맥구낭반박연합무창호흡궤가현저개선급성심기경사합병빙쇠갈환자적병정，은정혈류동역학상태，강저원내사망솔，위진일보적개선예후치료영득시간。
Objective:To explore the safety and effect of intra-aortic balloon counterpulsation (IABP) combined non-invasive ventilator on recent curative effect in patients with acute myocardial infarction (AMI) complicated pump failure after emergency percutaneous coronary intervention (PCI) .Methods:A total of 105 patients ,who hospital-ized in our CCU because of AMI complicated pump failure from Jul 2012 to Jun 2014 ,were selected .They were di-vided into IABP group (n=68 ,received IABP and noninvasive ventilator based on routine treatment ) and routine treatment group (n=37 ,received routine treatment and noninvasive ventilator therapy ) ,and all patients received e-mergency coronary angiography ,PCI and medication etc .Changes of blood pressure ,heart rate ,urine volume , echocardiography and brain natriuretic peptide (BNP) level etc .,and incidence of complications and cardiac adverse events were observed and compared between two groups during hospitalization . Results:Compared with routine treatment group during hospitalization ,blood pressure significantly rose and heart rate gradually declined to stable ;there was significant rise in left ventricular ejection fraction [(35 ± 9)% vs .(37 ± 10)% ] ,and significant reductions in BNP level [ (467 ± 197) pmol/L vs .(236 ± 146) pmol/L] ,mortality rate (28.9% vs .19.1% ) and hospital stay [ (16.2 ± 4.1) d vs .(11.6 ± 3.4) d] in IABP group , P<0.05~ <0.01 .Conclusion:IABP combined noninvasive ventilator can effectively improve patient′s condition ,stabilize hemodynamic status , reduce in-hospital mortality rate and gain time for further therapy to improve prognosis in patients with AMI complicated pump failure .