天津医药

• 短篇论著 • 上一篇    下一篇

主动脉内球囊反搏联合静脉替罗非班用于急诊冠状动脉介入治疗的临床观察

侯文广1,贾文军1,赵春杰2,程立松2   

  1. 1. 天津市人民医院
    2.
  • 收稿日期:2009-12-17 修回日期:2010-04-03 出版日期:2010-07-15 发布日期:2010-07-15
  • 通讯作者: 侯文广

The clinical observation of emergency PCI therapy within the IABP combined tirofiban through venous

  • Received:2009-12-17 Revised:2010-04-03 Published:2010-07-15 Online:2010-07-15

PDF (PC)

2090

摘要： 目的 探讨主动脉内球囊反搏（IABP）联合静脉替罗非班在急性心肌梗死（AMI）合并心源性休克(CS)患者经皮冠状动脉介入(PCI)治疗中的疗效。方法 26例AMI合并CS患者，在IABP及静脉替罗非班支持下行急诊PCI治疗，观察患者手术耐受性、血流动力学、心功能、血栓及出血并发症、病死率等情况。结果 术中除2例因梗死面积过大、泵衰竭死亡外，其余24例均顺利完成冠脉介入治疗并成功实施梗死相关血管（IRA）支架植入术，成功率92.31%，发病至血管再通的平均时间为8.13±2.82h；另外术后3例在监护室因心功能状况恶化死亡，住院期间总死亡率19.23%。未发现下肢动脉栓塞及致命性出血并发症（如颅内出血、内脏出血等）发生。存活病例血流动力学较治疗前有明显改善（P<0.05）；心功能状况较入院时有明显好转（P<0.05）。结论 IABP联合静脉替罗非班用于AMI合并CS患者急诊PCI治疗，可以较大程度地提高患者手术耐受性，改善血流动力学及心功能，减少并发症，降低死亡率。

关键词: 急性心肌梗死, 心源性休克, 主动脉内球囊反搏, 替罗非班, 经皮冠状动脉介入

Abstract: Objective To observation the efficacy of emergency PCI therapy within the IABP combined tirofiban through venous in acute myocardial infarction (AMI) merger cardiogenic shock (CS) patients. Methods 26 patients suffered acute myocardial infarction (AMI) merger heart shock (CS), we did emergency PCI therapy supported by the IABP combined tirofiban through venous, and the patients’ tolerance to operation , hemodynamics, cardiac function, thrombus and bleeding complications , mortality were observed. Results Except two cases died of large area of infarction and pump failure, 24 cases were finished the operation of PCI and stent implantation in infarction related artery (IRA), the success ratio is 92.31%. The average time from disease begin to vascular recanalization is 8.13±2.82h; another three postoperative patients died in ICU because cardiac function worse, the total hospitalization mortality is 19.23%. There is no limb artery embolization and deadly bleeding complications occurred (such as intracerebral hemorrhage, internal bleeding, etc.). The hemodynamics of survival cases was obvious improvement than before (P < 0.05), and the cardiac function get better compared with admission (P < 0.05). Conclusion The emergency PCI therapy within the IABP combined tirofiban through venous in acute myocardial infarction (AMI) merger cardiogenic shock (CS) patients, which can greatly improve patients’ tolerance to operation, improve the hemodynamics and cardiac function, reduce the complications and mortality.

Key words: acute myocardial infarction, cardiogenic shock, intra-aortic balloon pump, tirofiban, percutaneous coronary intervention