在大动脉内气球逆脉冲疗法期间内脏动脉损伤
Ardawan Julian Rastan1, Eugen Tillmann, Sreekumar Subramanian
1University of Leipzig, Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany. rastan@rz.uni-leipzig.de
Circulation
|September 15, 2010
概括
动脉内气球 (IABP) 错位在心脏手术患者中很常见,经常导致内脏动脉损伤. 需要更短的气球尺寸和改进的定位策略,以减少并发症和改善结果.
科学领域:
- 心血管外科心血管外科
- 医疗成像医学成像
背景情况:
- 内动脉气球 (IABP) 疗法是心脏外科手术中关键的循环支持方法.
- 在CT扫描中经常发现IABP错位和内脏动脉损伤,需要进一步调查.
研究的目的:
- 系统地审查心脏手术IABP患者的CT扫描.
- 为了确定IABP错位的原因,发病率和临床相关性.
主要方法:
- 对接受IABP支持的621名心脏手术患者的系统审查 (2007-2009).
- 在IABP支持期间,对63名患者进行胸腔腹部CT扫描的分析.
- 测量解剖距离并与气球尺寸进行比较.
主要成果:
- 通过CT在38.1%的患者中发现IABP错位,与X射线相比.
- 动脉损伤 (腹干,SMA,动脉) 在96.8%的位置不良患者中发现.
- 解剖与气球的长度不匹配发生在68.2%,与高死亡率 (60.3%) 和中肠缺血症 (23.8%) 相关.
结论:
- 电脑图像扫描通常在心脏外科手术中识别IABP错位.
- 错误的近位定位和解剖与气球的长度不匹配是错位的关键原因.
- 考虑更短的气球尺寸和增强的定位策略对于患者安全至关重要.
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