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目的通过观察经皮冠状动脉介入治疗(PCI)时,保护性主动脉球囊反搏装置(IABP)的应用对冠心病复杂病变患者手术耐受性、生命体征及术中、术后并发症的影响。方法 45例在IABP支持下行PCI的冠心病复杂病变患者为IABP组,将同期行PCI但没有行IABP支持的冠心病复杂病变患者49例设为对照组。观察对比两组在介入治疗的手术耐受性、有创血压、心率、肌钙蛋白、并发症发生率。结果 IABP组均能耐受手术,术后1例低血压,无急性、亚急性支架内血栓,死亡率为零。对照组有2例不能耐受手术,术中、术后因低血压心衰、再梗,需植入IABP5例,无复流2例,急性、亚急性支架内血栓2例,消化道出血1例,肾功能衰竭及多器官功能衰竭1例,死亡1例。结论在冠心病复杂病变治疗中,IABP的保护支持能明显提高手术耐受性和手术成功率,减少并发症,降低死亡率。
Objective To observe the surgical tolerance, vital signs, intraoperative and postoperative complications in patients with complicated coronary heart disease (CHD) by observing the application of protective aortic balloon pump (IABP) during percutaneous coronary intervention (PCI) influences. Methods Forty-five patients with IABP complicated with coronary artery disease complicated with PCI underwent IABP and 49 patients with complicated coronary artery disease who underwent PCI during the same period without IABP support. Observed and compared the two groups in the interventional treatment of surgical tolerance, invasive blood pressure, heart rate, troponin, the incidence of complications. Results All patients in IABP group were able to tolerate surgery. One postoperative hypotension, no acute and subacute stent thrombosis, the mortality rate was zero. There were 2 cases in the control group who were unable to tolerate surgery, 5 cases of IABP were implanted intraoperatively and postoperatively due to hypotension, 2 cases of no-reflow, 2 cases of acute and subacute stent thrombosis, 2 cases of gastrointestinal bleeding Cases, renal failure and multiple organ failure in 1 case, 1 died. Conclusion In the treatment of complicated coronary heart disease, IABP protection and support can significantly improve the surgical tolerance and success rate of surgery, reduce complications and reduce mortality.