Creswell L L, Rosenbloom M, Cox J L, Ferguson T B, Kouchoukos N T, Spray T L, Pasque M K, Ferguson T B, Wareing T H, Huddleston C B
Department of Surgery, Barnes Hospital, St. Louis, MO 63110.
Ann Thorac Surg. 1992 Jul;54(1):11-8; discussion 18-20. doi: 10.1016/0003-4975(92)91133-t.
Between January 1, 1986, and May 6, 1991, 7,884 cardiac surgical procedures requiring cardiopulmonary bypass were performed at our institution, including 672 (9.8% of adult procedures) performed in 669 patients that were associated with preoperative (n = 240), intraoperative (n = 353), or postoperative (n = 79) use of an intraaortic balloon pump. The mean age of recipients was 65.3 years (range, 16 to 89 years). Intraaortic balloon pump usage increased during the study period from 6.4% of patients (83/1,298) in 1986 to 12.7% of patients (169/1,333) in 1990. The relative distribution between preoperative (mean, 35.7%), intraoperative (52.5%), and postoperative (11.8%) insertion remained nearly constant during the study period. The overall operative (30-day) mortality for patients with preoperative, intraoperative, or postoperative insertion of the intraaortic balloon pump was 19.6%, 32.3%, and 40.5%, respectively (X2 = 16.4; p less than 0.001). Although use of the intraaortic balloon pump in the intraoperative and postoperative settings is accompanied by a favorable outcome in most patients, the high associated mortality suggests the need for earlier use of the intraaortic balloon pump or other supportive measures such as the ventricular assist device.
1986年1月1日至1991年5月6日期间，我院共进行了7884例需要体外循环的心脏外科手术，其中669例患者进行了672例手术（占成人手术的9.8%），这些手术与术前（n = 240）、术中（n = 353）或术后（n = 79）使用主动脉内球囊反搏有关。接受者的平均年龄为65.3岁（范围为16至89岁）。在研究期间，主动脉内球囊反搏的使用从1986年的6.4%（83/1298）增加到1990年的12.7%（169/1333）。术前（平均35.7%）插入、术中（52.5%）插入和术后（11.8%）插入的相对分布在研究期间几乎保持不变。术前、术中或术后插入主动脉内球囊反搏的患者的总体手术（30天）死亡率分别为19.6%、32.3%和40.5%（X2 = 16.4；p < 0.001）。虽然在术中及术后使用主动脉内球囊反搏在大多数患者中都有良好的结果，但高相关死亡率表明需要更早使用主动脉内球囊反搏或其他支持措施，如心室辅助装置。
