急诊主动脉球囊反搏泵安装术在急性心肌梗死合并复杂冠状动脉血管病变中的作用.docVIP

急诊主动脉球囊反搏泵安装术在急性心肌梗死合并复杂冠状动脉血管病变中的作用 　　作者：张健,刘全　　作者单位：吉林大学第一医院心血管诊疗中心，吉林 长春 130021 　　【摘要】目的：观察急诊主动脉球囊反搏泵安装术在急性心肌梗死合并复杂冠状动脉血管病变患者中的作用及重大意义。 方法：回顾性分析我院23例急性心肌梗死合并复杂冠状动脉血管病变危重患者即时行主动脉球囊反搏泵安装术的临床资料。男性15例，女性8例，年龄49～82岁，除2例为前降支开口闭塞外，均为急性心肌梗死合并三支血管严重病变和/或左主干病变，入院时剧烈胸痛，有心源性休克或心功能不全患者行主动脉球囊反搏泵安装术。其中1例为急性冠脉综合征，1例为急性非ST段抬高性心肌梗死，21例为急性ST段抬高性心肌梗死，6例同时行临时起搏器安装术，仅1入院期间未行支架置入，6例行二次经皮冠状动脉介入术。 结果：18例成功撤离IABP，患者症状得到明显改善，救治成功，5例死亡。抢救成功率=78.3%。结论：急诊主动脉球囊反搏泵安装术在救治急性心肌梗死合并复杂冠状动脉血管病变中发挥了重大作用及临床意义。 　　【关键词】 球囊起搏器,急性心肌梗死,复杂冠状动脉血管病变 　　Abstract：ObjectiveTo observe the role and significance of emergency intra-aortic balloon pump (IABP) in AMI patients with complex coronary artery lesions.MethodThe clinical data of 23 cases of severe AMI with complex coronary artery vascular disease timely treated by IABP in our hospital were retrospective analyzed (Male 15，female 8，aged 49～82 years old).Two cases were open occlusion of left anterior descending artery，and others were acute myocardial infarction complicated with 3 branches′ severe vascular disease and /or left main disease.Admission with severe chest pain，plused shock or heart failure received IABP.One case was acute coronary syndrome (ACS)，1 case was acute non-ST-segment elevation myocardial infarction (NSTEMI)，and 21 cases were acute ST-segment elevation myocardial infarction (STEMI).Six cases installated provisional pacemaker installation at the same time，only one case of PCI did not admit to the hospital during the surgery，6 cases of secondary PCI patients.ResultsFor 18 cases withdrawed IABP successfully，the symptoms were significantly improved，and 5 died.The rescue rate was 78.3%.ConclusionEmergency IABP surgery in the treatment of complex coronary artery lesions combined AMI plays a major role and has important clinical significance. 　　Key Words:Intra-aortic balloon pump counterpulsation;Acute myocardial infarction;Complex coronary artery lesions 　　目前主动脉内球囊反搏(intra-aortic balloon pump IABP)在急性心肌梗死(acute myocardial infarc