Alcan K E, Stertzer S H, Wallsh E, Bruno M S, DePasquale N P
Crit Care Med. 1984 Jun;12(6):489-95. doi: 10.1097/00003246-198406000-00004.
Retrospective analysis revealed that intra-aortic balloon counterpulsation was attempted in 321 patients at our institute from August 1, 1974, to July 1, 1982. The intra-aortic balloon pump (IABP) was successfully inserted in 298 cases (93%). Indications for an IABP included: cardiogenic shock (84 cases), preoperative hemodynamic coverage (15 cases), low-output syndrome (73 cases), pre- and postinfarction angina (75 cases), intractable congestive heart failure (12 cases), refractory ventricular arrhythmia (9 cases), percutaneous transluminal coronary angioplasty (14 cases), cardiac arrest (7 cases), and a miscellaneous group (9 cases). The overall major complication rate was 9%. The data from this experience support aggressive management of cardiogenic shock, i.e., early balloon insertion, angiography, and cardiac surgery, which significantly increases the survival rate (83%) over medical therapy combined with balloon counterpulsation alone. The IABP was also extremely effective in managing other high-risk categories when combined with some form of definitive mechanical correction, e.g., coronary revascularization, valve replacement, or percutaneous transluminal coronary angioplasty. Left ventricular (LV) function was a significant indicator of long-term survival in our series. Patients with normal or moderately impaired LV function had higher survival rates (95% and 82%, respectively) than patients with poor LV function (42%).
回顾性分析显示，1974年8月1日至1982年7月1日期间，我院对321例患者尝试进行主动脉内球囊反搏治疗。主动脉内球囊泵（IABP）成功植入298例（93%）。IABP的应用指征包括：心源性休克（84例）、术前血流动力学支持（15例）、低心排血量综合征（73例）、心肌梗死前后心绞痛（75例）、难治性充血性心力衰竭（12例）、难治性室性心律失常（9例）、经皮腔内冠状动脉成形术（14例）、心脏骤停（7例）以及其他杂项（9例）。总体主要并发症发生率为9%。该经验数据支持对心源性休克进行积极治疗，即早期植入球囊、血管造影和心脏手术，与单纯药物治疗联合球囊反搏相比，这显著提高了生存率（83%）。当与某种形式的确定性机械矫正（如冠状动脉血运重建、瓣膜置换或经皮腔内冠状动脉成形术）联合应用时，IABP在治疗其他高危类别方面也极其有效。在我们的系列研究中，左心室（LV）功能是长期生存的重要指标。左心室功能正常或轻度受损的患者生存率较高（分别为95%和82%），高于左心室功能较差的患者（42%）。
