Samad Khalid, Khan Fauzia Anis
Department of Anaesthesia and Intensive Care, Aga Khan University, Karachi.
J Pak Med Assoc. 2006 Jan;56(1):42-3.
Patients with recent myocardial infarction (MI), congestive heart failure, severe angina, or uncorrected multivessel coronary artery disease are at increased risk of cardiac complications after urgent major non-cardiac surgery. Although invasive haemodynamic monitoring and preoperative optimization of cardiac status may lead to some reduction in the rate of perioperative cardiac events, the mortality from such events still remains high. The use of an intra-aortic balloon pump (IABP) may play a role in such patients by improving the function of the injured heart. We report our experience with the use of perioperative IABP in a patient with unstable angina and recent MI who underwent urgent cholecystectomy. There were no perioperative cardiac events while the IABP was in place. The anaesthetic concerns, intraoperative and postoperative monitoring and care and usefulness of IABP will be discussed.
近期发生心肌梗死（MI）、充血性心力衰竭、严重心绞痛或未经矫正的多支冠状动脉疾病的患者，在进行紧急重大非心脏手术后发生心脏并发症的风险会增加。尽管有创血流动力学监测和术前心脏状态优化可能会使围手术期心脏事件发生率有所降低，但此类事件导致的死亡率仍然很高。主动脉内球囊反搏泵（IABP）的使用可能通过改善受损心脏的功能，在此类患者中发挥作用。我们报告了在一名患有不稳定型心绞痛和近期心肌梗死且接受了紧急胆囊切除术的患者中围手术期使用IABP的经验。在IABP使用期间未发生围手术期心脏事件。将讨论麻醉方面的注意事项、术中和术后的监测与护理以及IABP的效用。
