方曙.主动脉内球囊反搏改善急性心肌梗死后室间隔穿孔患者的临床疗效[J].内科急危重症杂志,2019,25(6):442-445
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| DOI：10.11768/nkjwzzzz20190602 |
| 中文关键词: 急性心肌梗死 室间隔穿孔 主动脉内球囊反搏 |
| 英文关键词: |
| 基金项目:国家自然科学基金(No:81470379) |
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| 摘要点击次数: 1881 |
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| 中文摘要: |
| 目的：探讨主动脉内球囊反搏（IABP）救治急性心肌梗死（AMI）后并发室间隔穿孔（VSR）的临床结局。方法：回顾性分析确诊AMI合并VSR的30例患者经IABP辅助治疗后临床结局资料。比较患者经IABP治疗前、后一般基线资料、血液动力学、心功能改善情况和院内死亡率。 结果：IABP能显著改善患者血液动力学和心功能，室间隔穿孔直径＞1.5cm是不良预后的危险因素。在IABP辅助下，室间隔穿孔直径＜1.5cm患者存活17例（56.7%），放弃1例，死亡4例；室间隔穿孔直径＞1.5cm患者存活2例（6.7%），放弃1例，死亡5例。结论：IABP救治AMI后并发VSR能显著改善血液动力学和心功能，降低死亡率和不良预后，但对室间隔穿孔直径＞1.5cm的患者机械支持效果有限，如何提高此类患者生存率需要进一步研究。 |
| 英文摘要: |
| Objective: To investigate the effect and prognosis of intra-aortic balloon pump (IABP) for acute myocardial infarction (AMI) complicated with ventricular septum rupture (VSR). Methods: The clinical data of patients with AMI complicated with VSR were analyzed retrospectively. The general baseline data, hemodynamics and cardiac function improvement of patients before and after IABP treatment were compared. Results: IABP significantly improved hemodynamics and cardiac function, and VSR with diameter greater than 1.5 cm was a risk factor for poor prognosis outcomes. With the assistance of IABP, among VSR diameter less than 1.5 cm, 17 patients (56.7%) survived, 1 withdrawn and 4 died, while among VSR diameter greater than 1.5 cm, 2 survived, 1 withdrawn and 5 died. Conclusion: IABP for VSR after AMI can significantly improve hemodynamics and cardiac function, and reduce mortality. However, auxiliary effects of IABP for patients with VSR with diameter greater than 1.5 cm are limited. To improve the survival rate of such patients warrants further study. |
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