主動脈內球囊反搏在主動脈瓣輕、輕中度反流患者中的應用_《中國胸心血管外科臨床雜志》

作者：

劉浩 , 丁芳寶 , 黃健兵等

上海交通大學醫學院附屬新華醫院心胸外科，上海 200092;

關鍵詞：

主動脈內球囊反搏主動脈瓣反流左心室射血分數心臟指數

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目的探討主動脈內球囊反搏（IABP）在主動脈瓣輕度和輕中度反流患者中使用的有效性和安全性。方法回顧性分析2006 年9 月至2011 年1 月上海交通大學醫學院附屬新華醫院心臟手術后15 例主動脈瓣輕中度反流伴左心室射血分數（LVEF）顯著減低（＜40.00%）患者行IABP 輔助的臨床資料，其中男11 例，女4 例；平均年齡63.60（50 ～ 74）歲。主動脈瓣輕度反流9 例，輕中度反流6 例，LVEF 均＜ 40.00%。術后放置IABP，比較患者使用IABP 前后的平均動脈壓(MAP)、心臟指數（CI）、全身血管阻力指數（SVRI）、肺循環阻力指數（PVRI）、 LVEF、主動脈瓣反流等指標。結果本組患者無死亡，患者使用IABP 后CI 較術前明顯改善，差異有統計學意義 [（3.30±0.29） L/（min·m2） vs.（ 1.99±0.23） L/（min·m2），t=48.30，P=0.00]，LVEF 高于使用IABP 前，差異有統計學意義（37.20%±1.37% vs. 42.60%±2.87%，t =11.34，P=0.00），SVRI 較使用IABP 前改善，差異也有統計學意義[（2 347.00±190.00）dyn ? s/（cm5? m2） vs.（ 2 128.00±204.00） dyn ? s/（cm5· m2），t=20.60，P=0.00］，主動脈瓣反流未見明顯增加（χ2=0.60，P=0.44）。結論對主動脈瓣輕度和輕中度反流伴LVEF 顯著減低患者心臟手術后進行IABP 輔助具有明顯的循環支持效果，且未增加主動脈瓣反流的風險。

引用本文： 劉浩,丁芳寶,黃健兵等. 主動脈內球囊反搏在主動脈瓣輕、輕中度反流患者中的應用. 中國胸心血管外科臨床雜志, 2012, 19(1): 48-51. doi: 復制

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2.	Davidson J, Baumgariner F, Omari B, et al. Intra-aortic balloon pump：indications and complications. J Natl Med Assoc, 1998, 90(3)：137-140.
3.	Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery： summary article： a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to update the 1999 guidelines for coronary Arte. Circulation, 2004, 110(9)： 1168-1176.
4.	Allie DE, Lirtzman M, Malik AP, et al. Rapid-staged strategy for concomitant critical carotid and left main coronary disease with left ventricular dysfunction：IABP use. Ann Thorac Surg, 1998, 66 (4)：1230-1235.
5.	Miceli A, Duggan SM, Capoun R, et al. A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(2)：522-526.
6.	Ranucci M, Ballotta A, Castelvecchio S, et al. Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion. Acta Anaesthesiol Scand, 2010, 54(7)：878-884.
7.	Bonios MJ, Pierrakos CN, Argiriou M, et al. Increase in coronary blood flow by intra-aortic balloon counterpulsation in a porcine model of myocardial reperfusion. Int J Cardiol, 2010, 138(3)：253-260.
8.	Trost JC, Hillis LD. Intra-aortic balloon counterpulsation. Am J Cardiol, 2006, 97(9)：1391-1398.
9.	Albertus S. Intra-aortic balloon counterpulsation therapy. Crit Care Nurse, 2006, 26(1)：14.
10.	Santini F, Bertolini P, Rossi A, et al. Unexpected complication of intra-aortic balloon counterpulsation via the ascending aorta：balloon migration. Eur J Cardiothorac Surg, 1997, 11(3)：579-581.
11.	Meisel S, Shochat M, Sheikha SA, et al. Utilization of low-profile intra-aortic balloon catheters inserted by the sheathless technique in acute cardiac patients：clinical efficacy with a very low complication rate. Clin Cardiol, 2004, 27(11)：600-604.
12.	Van WD, Bennink GB, Benatar AA. Complication of intra-aortic balloon pumping in a pediatric patient. Eur J Cardiothorac Surg, 1995, 9(10)：602-603.
13.	Papaioannou TG, Christodoulos S. Basic principles of the intraaortic balloon pump and mechanisms affecting its performance. Asaio J, 2005, 51(3)：296-300.
14.	Elahi MM, Chetty GK, Kirke R, et al. Complications related to intra-aortic balloon pump in cardiac surgery：a decade later. Eur J Vasc Endovasc Surg, 2005, 29(6)：591-594.
15.	Roy SK, Howard EW, Panza JA, et al. Clinical implications of thrombocytopenia among patients undergoing intra-aortic balloon pump counterpulsation in the coronary care unit. Clin Cardiol, 2010, 33(1)：30-35.
16.	Bream-rouwenhorst HR, Hobbs RA, Horwitz PA. Thrombocytopenia in patients treated with heparin, combination antiplatelet therapy, and intra-aortic balloon pump counterpulsation. J Interv Cardiol, 2008, 21(4)：350-356.

1. 　Laird JD, Madras PN, Jones RT, et al. Theoretical and experimental analysis of the intra-aortic balloon pump. Trans Am Soc Artif Intern Organs, 1968, 14：338-343.
2. 　Davidson J, Baumgariner F, Omari B, et al. Intra-aortic balloon pump：indications and complications. J Natl Med Assoc, 1998, 90(3)：137-140.
3. 　Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery： summary article： a report of the American College of Cardiology/American Heart Association task force on practice guidelines (committee to update the 1999 guidelines for coronary Arte. Circulation, 2004, 110(9)： 1168-1176.
4. 　Allie DE, Lirtzman M, Malik AP, et al. Rapid-staged strategy for concomitant critical carotid and left main coronary disease with left ventricular dysfunction：IABP use. Ann Thorac Surg, 1998, 66 (4)：1230-1235.
5. 　Miceli A, Duggan SM, Capoun R, et al. A clinical score to predict the need for intraaortic balloon pump in patients undergoing coronary artery bypass grafting. Ann Thorac Surg, 2010, 90(2)：522-526.
6. 　Ranucci M, Ballotta A, Castelvecchio S, et al. Perioperative heart failure in coronary surgery and timing of intra-aortic balloon pump insertion. Acta Anaesthesiol Scand, 2010, 54(7)：878-884.
7. 　Bonios MJ, Pierrakos CN, Argiriou M, et al. Increase in coronary blood flow by intra-aortic balloon counterpulsation in a porcine model of myocardial reperfusion. Int J Cardiol, 2010, 138(3)：253-260.
8. 　Trost JC, Hillis LD. Intra-aortic balloon counterpulsation. Am J Cardiol, 2006, 97(9)：1391-1398.
9. 　Albertus S. Intra-aortic balloon counterpulsation therapy. Crit Care Nurse, 2006, 26(1)：14.
10. 　Santini F, Bertolini P, Rossi A, et al. Unexpected complication of intra-aortic balloon counterpulsation via the ascending aorta：balloon migration. Eur J Cardiothorac Surg, 1997, 11(3)：579-581.
11. 　Meisel S, Shochat M, Sheikha SA, et al. Utilization of low-profile intra-aortic balloon catheters inserted by the sheathless technique in acute cardiac patients：clinical efficacy with a very low complication rate. Clin Cardiol, 2004, 27(11)：600-604.
12. 　Van WD, Bennink GB, Benatar AA. Complication of intra-aortic balloon pumping in a pediatric patient. Eur J Cardiothorac Surg, 1995, 9(10)：602-603.
13. 　Papaioannou TG, Christodoulos S. Basic principles of the intraaortic balloon pump and mechanisms affecting its performance. Asaio J, 2005, 51(3)：296-300.
14. 　Elahi MM, Chetty GK, Kirke R, et al. Complications related to intra-aortic balloon pump in cardiac surgery：a decade later. Eur J Vasc Endovasc Surg, 2005, 29(6)：591-594.
15. 　Roy SK, Howard EW, Panza JA, et al. Clinical implications of thrombocytopenia among patients undergoing intra-aortic balloon pump counterpulsation in the coronary care unit. Clin Cardiol, 2010, 33(1)：30-35.
16. 　Bream-rouwenhorst HR, Hobbs RA, Horwitz PA. Thrombocytopenia in patients treated with heparin, combination antiplatelet therapy, and intra-aortic balloon pump counterpulsation. J Interv Cardiol, 2008, 21(4)：350-356.

《中國胸心血管外科臨床雜志》

主動脈內球囊反搏在主動脈瓣輕、輕中度反流患者中的應用

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《中國胸心血管外科臨床雜志》

主動脈內球囊反搏在主動脈瓣輕、 輕中度反流患者中的應用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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主動脈內球囊反搏在主動脈瓣輕、輕中度反流患者中的應用

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