IABP在危重病患者中应用疗效观察.doc

IABP在危重病患者中应用疗效观察【摘要】目的：评价主动脉内球囊反搏(IABP)在危重病中应用的效果。方法：38例在应用中等剂量的血管活性药物不能改善低心排出量的危重病患者，立即使用KAATⅡPlusIABP（40 ml）进行循环功能支持。同时监测桡动脉和主动脉压力波形，应用PiCCOplus持续监测左心功能，记录尿量并观察末梢循环状况。结果：全组患者IABP辅助时间为(48±32)小时，早期生存率为78.20%。所有患者在应用IABP后，桡动脉收缩压均在早期有所下降(P＜0.01)；舒张压上升(P＜0.01)；平均动脉压增加；尿量明显增加。持续左心功能监测结果显示CO、CI于应用IABP后2小时明显恢复，48小时已经恢复到术前水平，外周阻力明显降低。结论：IABP对救治危重病患者低心排出量有重要作用，尤其是早期使用能大大降低死亡率，提高抢救生存率，值得推广。 【关键词】危重病；主动脉内球囊反搏 文章编号：1009-5519（2007）22-3329-03 中图分类号：R5 文献标识码：A Effect of IABP applied in patients with critical care YAN Han-wen，QIU Hai-bo，YANG Yi，et al. （Institute of Critical Care，The Zhongdo Hospital Affiliated to Southeast University Medical College，Jiangsu 210009，China） 【Ａbstract】Objective：To evaluate the effect of IABP applied in the patients with critical care.Methods：A total of 38 patients with critical care were given KAATⅡ plus IABP(40 ml) to support their circulation function when it was unable to improve the low cardiac output by secondary dose vascular activity drug,and the radial artery and the aorta pressure wave form were monitored at the same time.The PICC was used to monitor the left heart function and urinary output was recorded,and the peripheral circulation condition was observed.Results：The time of IABP subsidization was （48±３２）hours for all patients,the early survival rate was 78.20%.After IABP applied in this group,all radial arterial systolic pressure had decreased to some extent in the early period(P0.01),while the diastolic pressure raised(P0.01)；The average artery pressure increased;Urinary output increased obviously.The result of continuous left heart function monitoring showed that the C0 and C1 recovered obviously in 2 hours after using IABP and had already returned to the preoperative level in 48 hours,and the peripheral resistance decreased obviously.Conclusion：IABP played and important role in improving the low cardial output for the patients with critical care,and could greatly reduce the mortality and increase the survival rate in