IABP治疗心脏瓣膜置换术后低心排量综合征.pdfVIP

临床论著 I A B P治疗心脏瓣膜置换术后低心排量综合征 刘伯毅 罗 杰 郑 翔 秦成名 方 敏 季艳梅 郧阳医学院附属太和医院ICU室， 湖北 十堰 442000 【摘要1 目的 探讨主动脉内球囊反搏(Intra-aortic ba1loon pump，IABP)在心脏瓣膜置换术后低心排量综合征 中的应用。方珐 对1 2例心脏瓣膜置换术后出现低心排量综合征患者行IABP治疗，比较IABP治疗前后心率(HR)、 收缩压 (SBP)、舒张压(DBP)、平均动脉压 (MAP)、肺毛细血管嵌压(PCWP)、心脏指数(CI)、中心静脉压(CVP)、脉 搏氧饱和度(SP02)、尿量、多巴胺用量等指标的变化。同时观察患者IABP运用过程中并发症、预后等情况。 结幂 1 2例患者近期存活9例 (75．0％)，死亡3例 (25．0％)，发生IABP相关并发症患者4例 (33．3％)，无严重并发症 发生。IABP治疗后血流动力学改善明显(p0．05)，尿量增加(p0．05)，多巴胺用量减少(p0．05)。结论 IABP应 用于心脏瓣膜置换术后低心排量综合征的患者，可改善患者血流动力学指标，提高心脏指数，减少患者死亡率，改 善预后，应作为心脏瓣膜置换术后低心排量综合征患者首选治疗方法。 【关键词】主动脉内球囊反搏；低心排量综合征；瓣膜置换术 【中图分类号】R542．5 【文献标识码】A 【文章编号I l 009—3257(2008)01-0023-04 The therapy of IABP on the patients with low cardiac output syndrome after cardiac valve replacement LIU Bo-yi，LUO Jie．ZHENG Xiang．et a1．Department of ICU，Taihe Hospita[．Yunyang Medical CoUpe．S~yan．Hubei 442000．China 【Abstract】 Objective To explore the appHcation of intra—aortic baHoon pump(IABP)in the patients who had low cardiac output syndromes after cardiac valve replacements． Method~ 1 2 patients with low cardiac output syndromes after cardiac valve replacements were performed with IABP．Before and after the IABP．the variation of the indexes including heart rate(HR)，systolic pressure(SBP)，diastolic pressure(DBP)，mean arterial blood pressure (MAP)，pulmonary capillary wedge pressure(PCWP)。cardiac index(CI)，central venous pressure(CVP)。blood oxygen saturation(SPO2)。urine volume and dosage of dopamine were compared．Simultaneously。the complication and prognosis in the application process of IABP were observed． Resu／ts In the 12 patients．9 survived in the near future(75．O％)，3 died(25．0％)，4 with were complication association IABP(33．3％)，and there was no severe complication．After the therapy of IABP，the index of tmemodynamics improved significantly(p0．05)，the urine VOlume increased(p0．05)。and the dosage of dopamine decreased(pO．05)． Conclusion For the patients with low cardiac output syndrome after cardiac v