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目的探讨拟行急诊经皮冠脉介入治疗(PCI)的急性心肌梗死(AMI)伴心源性休克(CS)患者入院后即刻行主动脉球囊反搏(IABP)治疗的临床疗效及安全性。方法回顾分析2012年1月-2015年6月就诊于我院的AMI合并CS患者52例,即刻IABP组27例,未行即刻IABP组25例,分析2组患者的门—球囊时间及治疗效果。结果即刻IABP组在行PCI术前(具体指置入支架前)死亡3例(11.1%),未行即刻IABP组在行PCI术前死亡6例(24.0%),2组比较存在统计学差异(P<0.05)。即刻IABP组门—球囊时间为(93.5±10.7)min显著短于未行即刻IABP组的(127.9±15.4)mim,两组比较有统计学差异(P<0.05)。即刻IABP组死亡6例(22.2%),未行即刻IABP组死亡10例(40.0%),2组比较存在统计学差异性(P<0.05)。结论在可能会发生PCI手术延迟的情况下,对AMI合并CS的患者应及早,尽快使用IABP治疗,以缩短门—球囊时间,降低病死率。
Objective To investigate the clinical efficacy and safety of aortic balloon pump countermeasures (IABP) in patients undergoing acute percutaneous coronary intervention (PCI) with acute myocardial infarction (AMI) and cardiogenic shock (CS) . Methods A retrospective analysis of 52 patients with AMI with CS in our hospital from January 2012 to June 2015 was retrospectively analyzed. Twenty-seven patients in the IABP group immediately after operation and 25 patients in the immediate IABP group were analyzed. The portal-balloon time and treatment effect. Results Three patients (11.1%) died immediately before PCI (before stent placement) in the IABP group, 6 patients (24.0%) died before PCI in the immediate IABP group, there was a significant difference between the two groups (P <0.05). The mean time between sacral balloon and IABP was (93.5 ± 10.7) min in IABP group (127.9 ± 15.4) mim, which was significantly different between the two groups (P <0.05). There were 6 cases (22.2%) died immediately in IABP group and 10 cases (40.0%) died immediately in IABP group, there was statistical difference between the two groups (P <0.05). Conclusion Patients with AMI complicated with CS should be treated with IABP as soon as possible in order to shorten the time of portal-balloon and reduce the mortality in the case of delayed PCI.