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"主动脉内球囊反搏" 18 results
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Objective To compare the assisting function between a new paraaortic counterpulsation device (PACD) and the intraaortic balloon pump (IABP) in acute severe heart failure in sheep. Methods Eight healthy adult small fattailed sheep were chosen in our study. The selfmade PACD (with a stroke volume of 55 ml) was anastomosed to the descending aorta through a valveless graft, and an intraaortic balloon (with a stroke volume of 40 ml) was placed in the descending aorta for the purpose of counterpulsation assisting. Acute severe heart failure model was established by snaring coronary artery branches. The hemodynamic changes of both devices were recorded during, before and after the counterpulsation assisting. Results Eight heart failure sheep models were successfully set up. Cardiac output (CO), pulmonary capillary wedge pressure (PCWP), mean arterial pressure (MAP) and left ventricular end diastolic presssure (LVEDP) after the heart failure were significantly different compared with basic value (t=-8.466, 34.083, 25.767, -5.219, P=0.000). After IABP and PACD assisting, the mean aortic diastolic pressure (MADP) didn’t significantly or did increase (38.34±7.13 mm Hg vs. 38.42±6.81 mm Hg, P=0.418; 38.34±7.13 mm Hg vs.54.14±10.13 mm Hg, P=0.001), and the degree of increasing between the two methods showed a significant difference (P=0.010); LVEDP didn’t significantly decrease (7.43±2.54 mmHg vs. 7.32±2.14 mm Hg, P=0.498; 7.43±2.54 mm Hg vs. 6.53±1.91 mm Hg, P=0.821), and there was no significant difference between the two methods in the change (P=0.651); the coronary sinus flow (CSF) didn’t significantly or did increase (86.63±7.71 ml/min vs. 87.04±6.53 ml/min, P=0.981; 86.63±7.71 ml/min vs. 110.52±11.03 ml/min, P=0.000), and there was a significant difference in the change of CSF between the two methods (P=0.000). IABP didn’t significantly decrease the left carotid artery flow (LCAF) (131.07±21.26 ml/min vs. 128.36±20.38 ml/min, P=0.689), while PACD increased it (131.07±21.26 ml/min vs. 151.29±18.37 ml/min, P=0.008), and there was a significant difference in the change of pressure waveform between the two methods (P=0.002). The thrombus, thrombosis and ischemic necrosis were not found in the hematosac of PACD, artificial blood vessels, heart, lung, liver or kidney of the animal. No apparent abnormalities of the pathohistological sections were detected under optical microscope. Conclusion IABP has no assisting function for the heart of animal with severe heart failure. However, PACD can improve hemodynamic parameters like MADP, returned blood volume in the coronary artery and perfusion volume into the brain, which may become a promising implantable device for severe heart failure.
Release date：2016-08-30 05:56
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ObjectiveTo evaluate the clinical efficacy of preoperative intra-aortic balloon pump (IABP) insertion in patients with off-pump coronary artery bypass grafting (OPCABG) surgery.MethodsThe clinical data of 130 patients who underwent OPCABG with IABP from 2015 to 2019 in our hospital were retrospectively analyzed. The patients were divided into two groups, including a group A (preoperative IABP insertion, n=72) and a group B (emergent IABP insertion, n=58). There were 42 males and 30 females in the group A with an average age of 60-72 (65.0±5.2) years. There were 32 males and 26 females in the group B with an average age of 56-73 (62.3±7.6) years. The in-hospital mortality rate and prognosis were compared between the two groups.ResultsThe in-hospital mortality rate in the group A (4.2%) was significantly lower than that in the group B (12.1%, P=0.002). The IABP time (40.8±10.3 min vs. 65.3±15.6 min), mechanical ventilation time (18.7±6.1 min vs. 48.7±10.5 min) and ICU stay time (48.1±7.8 min vs. 90.2±21.3 min) of the group A were shorter than those of the group B (P<0.05). The number of bypass grafts was not significantly different between the two groups (3.6±1.2 vs. 3.8±1.0, P=0.387). Multivariable logistic regression analysis indicated that independent risk factors for in-hospital mortality included age [OR=1.04, 95%CI (1.01, 1.10), P=0.030], female [OR=2.56, 95%CI (1.53, 6.12), P=0.000] and left ventricular end-diastolic diameter [OR=1.05, 95%CI (1.01, 1.13), P=0.030]. Preoperative IABP support was the protective factor [OR=0.17, 95%CI (0.01, 0.78), P=0.005].ConclusionPatients undergoing OPCABG with preoperative IABP insertion may reduce in-hospital mortality rate and improve outcomes.
Release date：2021-10-28 04:13
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目的 为提高冠状动脉旁路移植术(CABG)的手术疗效, 总结CABG围手术期主动脉内球囊反搏(IABP)应用的临床经验. 方法 回顾性分析46例CABG围手术期行IABP患者的临床资料及IABP放置的原因、时间和预后. 结果 34例康复出院,住院死亡12例,主要死亡原因:低心排血量综合征、肺部感染、多器官功能衰竭等.平均IABP辅助时间28.6±18.2小时.IABP能使平均动脉压升高,心排血量增加,有助于心脏功能差的患者脱离体外循环和改善心脏不停跳冠状动脉旁路移植术(OPCAB)中心脏对稳定器压迫的耐受性. 结论 IABP是一种简单有效的循环辅助手段,心功能差的高危CABG患者应及时放置IABP.放置IABP前应查明下肢血管情况,避免血管损伤.
Release date：2016-08-30 06:30
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Objective
To investigate the changes of hemodynamics in patients weaning intra-aortic balloon pump (IABP) by using progressive volume deflation followed by rate reduction.
Methods
We retrospectively analyzed the clinical data of 36 patients aged 68.9±4.7 years, 22 males and 14 females, who underwent progressive volume deflation followed by rate reduction for IABP weaning in Xinhua Hospital between September 2006 and January 2016. Progressive volume deflation followed by rate reduction was used to wean IABP and collect hemodynamics parameters of each time point.
Results
All the patients successfully weaned IABP. One patient got re-IABP assistant 36 hours after the first successful weaning. One early death and three patients (8%) with postoperative IABP-related complications were embolization of the toe artery. One was in ipsilateral limb, and two of contralateral limb. One patient with acute hepatic insufficiency and one patient with acute renal insufficiency cured after treatment.
Conclusion
Intra-aortic balloon pump weaning is successful by using volume deflation followed by rate reduction which allowed better hemodynamic parameters.
Release date：2018-03-05 03:32
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目的探讨体外膜肺氧合联合主动脉内球囊反搏术在心脏术后急性心力衰竭中的应用。方法回顾性分析 2012 年 10 月至 2017 年 10 月我院心外三科因急性心力衰竭接受体外膜肺氧合联合主动脉内球囊反搏治疗 38 例患者的临床资料，探索联合应用在心脏术后中的作用。男 24 例、女 14 例，平均年龄（58±11）岁。结果24 例患者成功撤离机械辅助装置，其中 16 例患者存活出院。死亡组肾功能衰竭的发生率显著高于生存组，差异有统计学意义。在不能脱机组的患者中，混合静脉血氧饱和度未见明显好转。结论体外膜肺氧合联合主动脉内球囊反搏可能具有协同作用，在心脏术后急性心力衰竭的治疗中起到一定的辅助作用。
Release date：2019-01-03 04:52
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Objective
To analyze the results of intra-aortic balloon pump (IABP) support in patients receiving coronary artery bypass graft (CABG) and the risk factors of postoperative death.
Methods
The clinical data of 334 patients undergoing CABG procedure and receiving IABP support in Fuwai Hospital from January 1999 to April 2012 were retrospectively analyzed. According to the IABP insertion timing, the patients were divided into three groups: pre-, intra- and postoperative IABP groups. There were 45 males and 11 females aged 60.5±10.7 years in the preoperative IABP group, 84 males and 23 females aged 61.1±8.4 years in the intraoperative IABP group and 119 males and 52 females aged 61.4±8.5 years in the postoperative IABP group.Outcomes of the three groups were compared, including mortality, major complications, ICU stay, hospital stay and total costs. Multivariable logistic regression analysis was used to predict independent risk factors for postoperative in-hospital death.
Results
The total in-hospital mortality was 16.8% (56/334). Mortality was significantly different among the pre-, intra- and postoperative IABP groups (3.6% vs.23.4%vs. 17.0%, P=0.006). There was no significant difference in complications among the three groups (P=0.960). Multivariable logistic regression analysis indicated that independent risk factors for postoperative mortality included old age (OR=1.05, P=0.040), female (OR=3.34, P<0.001) and increasing left ventricular end-diastolic diameter (LVEDD,OR=1.06, P=0.040). Preoperative IABP support was protective factor (OR=0.10, P=0.050).
Conclusion
The results of IABP support in CABG patients are satisfactory, and patients with preoperative IABP have a lower mortality. Risk factors for postoperative death include old age, female and increasing LVEDD. Preoperative IABP support is a protective factor.
Release date：2018-06-01 07:11
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目的探讨心脏瓣膜置换术后早期心肌顿抑的诊断及治疗以及其所引起的低心排血量综合征（LCOS）的诊疗。 方法回顾性分析我院 2011 年 1 月至 2018 年 3 月期间 42 例心脏瓣膜置换术后早期出现心肌顿抑导致 LCOS 患者的临床资料，其中男 19 例、女 23 例，年龄 38～55（47.91±5.51）岁。术前左心室舒张末期内径（LVEDD）3.8～6.5（5.3±0.9）cm，左心室射血分数（EF）45%～60%（51.2%±5.3%）；冠状动脉粥样硬化性心脏病筛查均为阴性；其中单纯主动脉瓣置换 12 例，二尖瓣置换合并三尖瓣成形 15 例，二尖瓣和主动脉瓣置换 15 例。 结果42 例患者均在术后早期［10～24（18.83±4.24）h］出现无明确原因的 LCOS，大剂量肾上腺素［0.06～0.10 μg/（kg·min）］和去甲肾上腺素［0.1～0.5 μg/（kg·min）］治疗无效而加用主动脉内球囊反搏（IABP）治疗，其中 25 例患者行肾脏替代治疗（CRRT）。IABP 辅助时间 3～10（5.16±1.95）d，CRRT 治疗时间 22～61（42.17±10.75）h。40 例患者痊愈出院，2 例患者院内死亡，1 例死于脓毒血症，1 例患者死于恶性心律失常。 结论心脏瓣膜置换术后早期出现心肌顿抑引起病情突变恶化，如能早期诊断、早期治疗，将取得好的临床结果。IABP 可以减轻心脏负荷，增加冠状动脉灌注，改善循环，有助于患者渡过心肌顿抑期；CRRT 可以改善 LCOS 患者内环境，减轻肾脏负担。两者是成功救治此类患者的重要手段。
Release date：2019-03-01 05:23
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目的 评价主动脉内球囊反搏(IABC)治疗心脏手术后室性心律失常的效果。 方法 对33例因心脏手术后出现室性心律失常使用IABC的病例进行分析，观察心律恢复情况、ST段转复情况、监测桡动脉和主动脉压力波形，记录血管活性药物用量。 结果 所有患者在应用IABC后1～2小时室性心律失常由原来的Ⅱ～Ⅴ级恢复到0～Ⅰ级(Lown分级)。ST段的抬高或降低在30分钟～1小时后恢复正常。所有患者在应用IABC后，桡动脉压的基础收缩压均在早期有所下降，从90±19mmHg下降到78±21mmHg(P＜0.05)；基础舒张压从71±16mmHg上升到131±25mmHg(P＜0.01)；平均动脉压增加。多巴胺用量由8±2μg/mlh下降至3±2μg/mlh。 结论 IABC能够有效地控制体外循环手术后室性心律失常的发生，为治疗心脏手术后室性心律失常的一种新方法。
Release date：2016-08-30 06:33
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【摘要】 目的 探讨使用主动脉内球囊反搏治疗过程中护理措施对改善患者预后的影响。 方法 选择我科2008年9月〖CD3/5〗2009年5月使用主动脉内球囊反搏治疗急性心肌梗死伴心源性休克的9例患者,对治疗过程进行了观察及全面合理的护理。 结果 主动脉内球囊反搏治疗患者,取得了满意的效果。 结论 主动脉内球囊反搏患者病情复杂危重,使用过程中需辅以全面合理的护理措施,防止并发症发生,对改善患者预后有益。
Release date：2016-09-08 09:45
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目的 探讨心瓣膜置换术后早期心肌顿抑的识别、诊断，以及由此导致严重低心排血量综合征（LCOS）的治疗方法，以提高诊断、治疗水平。 方法 回顾分析我科2004年9月至2006年9月期间4例心瓣膜置换术后早期出现心肌顿抑导致LCOS患者的临床资料，4例均为女性，年龄35～54岁，平均年龄46-75岁。术前左心室大小、收缩功能均基本正常，左心室舒张期末内径（LVEDD)3.5～6.3 cm，射血分数(EF)49%～61%；2例行二尖瓣、主动脉瓣置换术，1例行二尖瓣置换术，1例行主动脉瓣置换术。 结果 4例患者均在术后早期（14～40 h、平均26 h）出现无明确原因的LCOS，给予大剂量肾上腺素［0.10～0.15 μg/(min·kg）］治疗无效而改行主动脉内球囊反搏（IABP）治疗，4例患者IABP支持时间为7～12 d（平均8.5 d），3例痊愈，1例因肺部感染于术后28 d死于多器官功能衰竭。2例出现急性肾功能不全，1例7 d后肾功能恢复正常，1例经腹膜透析治疗2周后痊愈。 结论 心肌顿抑可出现在术前心功能良好，手术经过顺利的心瓣膜置换术患者，由心肌顿抑导致的术后早期LCOS，及时应用IABP可以减轻心脏负荷，增加冠状动脉灌注，改善重要脏器循环，有助于左心室渡过心肌顿抑期，恢复收缩功能，是成功救治的重要手段。
Release date：2016-08-30 06:06
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