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目的 对采用主动脉内球囊反搏 (IABP)治疗的心源性休克和心脏破裂病人的住院死亡情况进行回顾性分析。方法 对心源性休克和心脏破裂的 2 8例病人 ,均安装IABP ,其中 2 0例进行了冠状动脉造影 ,1 3例接受了冠状动脉成形术 (PTCA)、冠脉旁路移植术 (CABG)或心脏外科手术。结果 1例因急诊血管成形失败而行急诊CABG成功 ,1 1例急诊血管成形 (直接PTCA)开通了梗死相关动脉 (IRA) ,1 2例 (42 9% )存活 ,1 6例死亡 (57 1 % ) :1 1例因休克死亡 ;4例心脏破裂因没有手术干预的时机死亡 ;1例游离壁破裂因心肌坏死面积过大死于手术台上 ;还有 1例病人在出院 7d后死于室颤。在所有无心脏破裂的心源性休克病人中 ,与接受PTCA和CABG的病人相比 ,未接受PTCA和CABG的病人的死亡率较高 (81 8%vs1 6 7% )。所有心脏破裂的病人无一存活 ,死亡率 1 0 0 %。结论 使用IABP对于急性心肌梗死 (AMI)所致的心源性休克有显著的效果 ,但仅使用IABP结合常规治疗而不开通IRA并不能提高这些病人的生存率 ,心脏破裂的病人若不能及时修补缺损 ,使用IABP仅能延长病人的存活时间 ,不能改善病人的生存率
Objective To retrospectively analyze the in-hospital mortality of patients with cardiogenic shock and heart-rupture treated with intra-aortic balloon counterpulsation (IABP). Methods Twenty-eight patients with cardiogenic shock and heart rupture were enrolled in this study. 20 patients underwent coronary angiography and 13 received coronary angioplasty (PTCA), coronary artery bypass grafting (CABG) ) Or heart surgery. Results One case of emergency CABG was unsuccessful for emergency angioplasty. Eleven patients with acute angioplasty (direct PTCA) developed infarct-related artery (IRA), 12 (42.9%) survived and 16 died %): 11 cases of death due to shock; 4 cases of heart rupture due to no operative intervention at the time of death; 1 case of free wall rupture due to myocardial necrosis overdose on the operating table; and 1 patient died after 7 days of discharge Ventricular fibrillation. In all patients with cardiogenic shock without heart failure, patients who did not receive PTCA and CABG had a higher mortality rate (81 8% vs 167%) than those who received PTCA and CABG. None of the patients with ruptured heart survived, with a 100% mortality rate. Conclusions The use of IABP has a significant effect on cardiogenic shock induced by acute myocardial infarction (AMI). However, the use of IABP in combination with conventional therapy without the use of IRA does not improve the survival rate of these patients. Patients with heart rupture, if not timely repaired Defects, the use of IABP can only extend the patient’s survival time, can not improve the patient’s survival rate