紧急冠状动脉绕道用于心脏性休克
R A Guyton1, J M Arcidi, D A Langford
1Department of Medicine, Carlyle Fraser Heart Center, Crawford W. Long Memorial Hospital, Emory University School of Medicine, Atlanta, GA.
Circulation
|November 1, 1987
概括
应急冠状动脉旁路手术用于心脏性休克显示了改善的生存率. 这项研究发现,休克患者的住院死亡率为12%,88%的患者在手术后3年生存.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 关键护理医学 关键护理医学
背景情况:
- 应急冠状动脉绕道 (CAB) 为心脏性休克传统上携带高的手术死亡率.
- 这一高风险群体的患者管理和结果需要进一步调查.
研究的目的:
- 为了评估紧急冠状动脉旁路手术在患有和没有心脏性休克的患者的结果.
- 为了比较两个群体之间的并发症率,死亡率和长期存活率.
主要方法:
- 在1983年1月至1986年3月期间,对69名接受紧急CAB治疗的患者进行了回顾性分析.
- 患者被分为两组:心脏性休克患者 (n=17) 和没有休克患者 (n=52).
- 收集的数据包括人口统计,手术前情况,手术内支持,术后并发症,死亡率和长期随访.
主要成果:
- 心脏性休克组的住院死亡率为12%,而非休克组的死亡率为2% (p < .05).
- 术后,94%的休克患者需要甲基荷兰胺,71%需要大动脉内气球支持,明显高于非休克组 (p < .05).
- 冲击组的三年生存率为88% +/- 8%,非冲击组为91% +/- 4%. 严重并发症发生在47%的冲击组,而非冲击组的13% (p < .05).
结论:
- 患有心脏性休克患者的紧急冠状动脉旁路手术,虽然与较高的死亡率和并发症率相关,但可以实现可接受的长期生存.
- 仔细选择患者和术后管理对于改善这一高风险人群的治疗结果至关重要.
- 该研究强调了急诊CAB的休克和非休克患者在资源利用和并发症方面的显著差异.
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