Millat M H, Cameron E W J
Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, UK.
Ir J Med Sci. 2003 Oct-Dec;172(4):177-9. doi: 10.1007/BF02915285.
Oesophagogastrectomy for carcinoma has a high operative mortality rate. Patients are elderly and ischaemic heart disease (IHD) is a recognised and frequent risk factor.
To illustrate the use of the intra-aortic balloon pump (IABP) as prophylaxis against cardiac complications in a group of such patients.
Five patients aged from 63 to 78 years were presented with operable adenocarcinoma of the oesophagus. They had IHD of a severity thought to pose a risk of myocardial infarction (MI) and/or failure at the time of oesophagogastrectomy. With the induction of anaesthesia, the IABP was inserted and left in situ for up to 24 hours.
There were no major adverse perioperative cardiac events. Four patients were discharged from hospital on the eighth and one on the tenth postoperative day.
The prophylactic use of IABP has a potential role in the prevention of cardiac complications in patients with IHD undergoing high risk non-cardiac surgery.
食管癌胃切除术的手术死亡率很高。患者多为老年人，缺血性心脏病（IHD）是一个公认的常见风险因素。
阐述主动脉内球囊反搏泵（IABP）在这类患者中预防心脏并发症的应用。
5例年龄在63至78岁之间的患者，患有可手术切除的食管腺癌。他们患有严重程度被认为在食管癌胃切除术时会有心肌梗死（MI）和/或心力衰竭风险的缺血性心脏病。在麻醉诱导时，插入IABP并留置原位长达24小时。
围手术期无重大不良心脏事件。4例患者在术后第8天出院，1例在术后第10天出院。
预防性使用IABP在预防患有缺血性心脏病的患者进行高风险非心脏手术时的心脏并发症方面具有潜在作用。
