中国体外循环杂志2018，Vol.16Issue(1)：16-20,11,6.DOI:10.13498/j.cnki.chin.j.ecc.2018.01.05
冠状动脉粥样硬化性心脏病伴轻度左心功能不全患者围术期应用主动脉内球囊反搏早中期结果分析
Early and mid-term results of perioperative intra-aortic balloon pumping in patients with coronary artery disease and mild left ventricular dysfunction
摘要
Abstract
Objective To analyze the early and mid-term outcomes of perioperative application of intra-aortic balloon pumping (IABP) in coronary artery disease (CAD) patients with mild left function insufficiency undergoing coronary artery bypass grafting (CABG) in a single centre. Methods Clinical data of patients with CAD and mild left ventricular dysfunction who underwent CABG between May 1995 to July 2014 in our department were retrospectively analyzed. The patients were divided into IABP group and non IABP group according to the perioperative application. Preoperative left ventricular ejection fraction (LVEF), EuroSCORE Ⅱ predicted mortality and in-hospital mortality were noted. Logistic regression analysis was performed to reveal the major risk factors of death. The postoperative 7-year survival rate and freedom from MACCEs were compared between the two groups. Results A total of 480 patients were included in the study, 44 patients in IABP group and 436 patients in non-IABP group. Preoperative LVEF in IABP group was lower than that in non-IABP group. The EuroSCORE Ⅱ predicted mortality of IABP group was higher than non - IABP group. There was no difference in in-hospital mortality between the two groups. Logistic regression analysis showed that perioperative IABP implantation, recent myocardial infarction (MI), preoperative critical status, days of ICU stay, postoperative ventricular fibrillation (VF) were the independent risk factors of in-hospital death. Perioperative IABP implantation is associated with reduced in-hospital mortality. There was no difference in the mid-term survival rate between the two groups. But the incidence of MACCEs in IABP group was higher than non-IABP group. Conclusions Perioperative IABP implantation, recent MI, preoperative critical status, postoperative VF, ICU days were the independent risk factors for CAD with mild left ventricular dysfunction patients undergoing CABG. Perioperative IABP implantation is a protective factor in reducing in-hospital mortality. Application of IABP may achieve good early and mid -term effects, but it may also increase the ventilation time, ICU days and the incidence of mid-term MACCEs.关键词
主动脉内球囊反搏/冠状动脉粥样硬化性心脏病/左心功能不全/冠状动脉旁路移植术/围术期/生存率/主要不良心脑血管事件Key words
Intra - aortic balloon pumping/Coronary artery disease/Left ventricular dysfunction/Coronary artery bypass grafting/Perioperative period/Survival rate/Major adverse cardiac or cerebrovascular events引用本文复制引用
何潇一,王嵘,高长青,龚志云,成楠..冠状动脉粥样硬化性心脏病伴轻度左心功能不全患者围术期应用主动脉内球囊反搏早中期结果分析[J].中国体外循环杂志,2018,16(1):16-20,11,6.基金项目
国家重点研发计划资助(项目编号2016YFC1301400) （项目编号2016YFC1301400）
