Nursing practice of extracorporeal membrane oxygenation combined with intra aortic balloon pulsation in selective high risk percutaneous coronary intervention
YANG Li1 ZHANG Yamin1 GAO Haokao1 LIAN Kun1 HAN Peng2▲
1.Department of Cardiovascular Medicine, the First Affiliated Hospital of Air Force Medical University of the People’s Liberation Army (Xijing Hospital), Shaanxi Province, Xi’an, 710032, China;
2.NO.981 Hospital of the People’s Liberation Army Joint Logistic Support Force, Hebei Province, Chengde 067000, China
Abstract：Objective To explore the nursing measures of extracorporeal membrane oxygenation (ECMO) combined with Intra aortic balloon pulsation (IABP) in percutaneous coronary intervention (PCI). Methods From May 2018 to April 2020, 43 patients who underwent high-risk coronary PCI with circulation support of ECMO combined with IABP in the Department of Cardiovascular Medicine, the First Affiliated Hospital of PLA Air Force Medical University of the People’s Liberution Army (Xijing Hospital) were continuously included, mainly summarizing the general nursing of perioperative patients, ECMO and IABP instrument and related complications. Results A total of 43 high-risk PCI patients were successfully implanted with ECMO and IABP during operation and removed ECMO half an hour after PCI. Except three patients died in hospital, the other 40 patients were successfully removed ECMO and recovered and discharged. The ECMO running time was (7.67±3.79) h, the IABP auxiliary time was 44.50 (24.25, 72.00) h, and the hospitalization time was (13.79±5.08) d. Malignant arrhythmia occurred in five cases during operation and complications occurred in seven cases after operation. Conclusion ECMO combined with IABP assisted high-risk PCI is an important guarantee to ensure the successful and effective implementation of high-risk PCI.
杨丽1 张亚敏1 高好考1 廉坤1 韩鹏2▲. 择期高危经皮冠脉介入术中体外膜肺氧合联合主动脉内球囊反搏的护理实践[J]. 中国医药导报, 2020, 17(32): 156-159,168.
YANG Li1 ZHANG Yamin1 GAO Haokao1 LIAN Kun1 HAN Peng2▲. Nursing practice of extracorporeal membrane oxygenation combined with intra aortic balloon pulsation in selective high risk percutaneous coronary intervention. 中国医药导报, 2020, 17(32): 156-159,168.
[1] Joo ML，Jonghanne P，Jeehoon K，et al. The efficacy and safety of mechanical hemodynamic support in patients undergoing high-risk percutaneous coronary intervention with or without cardiogenic shock：Bayesian approach network meta-analysis of 13 randomized controlled trials [J]. Inter J Cardiol，2014，64（11）：B19.
[2] Amneet S，Lisa AM，Smita IN，et al. Use of mechanical circulatory support in patients undergoing percutaneous coronary intervention：insights from the National Cardiovascular Data Registry [J]. Circulation，2015，132（13）：1243-1251.
[3] 陈宇，裴宜宾，曹毅，等.体外膜肺氧合联合主动脉内球囊反搏在高危患者经皮冠状动脉介入治疗中的应用[J].中国介入心脏病学杂志，2019，27（4）：211-215.
[4] O′gara PT，Kushner FG，Ascheim DD，et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction：a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines [J]. J Am Coll Cardiol，2013，61（4）：e78-e140.
[5] Tomasello SD，Boukhris M，Ganyukov V，et al. Outcome of extracorporeal membrane oxygenation support for complex high risk elective percutaneous coronary inter-ventions：a single-center experience [J]. Heart Lung，2015，44（4）：309-313.
[6] 刘长智，朱瑞秋，苏用鹏，等.体外膜肺氧合治疗难治性心源性休克期间并发心肌顿抑的临床研究[J].中华急诊医学杂志，2019，28（7）：846-849.
[7] Guenther S，Theiss HD，Fischer M，et al. Percutaneous extracorporeal life support for patients in therapy re-fractory cardiogenic shock：initial results of an interdisci plinary team [J]. Interact Cardiovasc Thorac Surg，2014，18（3）：283-291.
[8] Madershahian N，Wippermann J，Liakopoulos O，et al. The acute effect of IABP-induced pulsatility on coronary vascular resistance and graft flow in critical ill patients during ECMO [J]. Cardiovasc Surg，2011，52（3）：411-418.
[9] Gass A，Palaniswamy C，Aronow WS，et al. Peripheral veno-arterial extracorporeal membrane oxygenation in combination with intra-aortic balloon counter-pulsation in patients with cardiovascular compromise [J]. Cardiology，2014，129（3）：137-143.
[10] Goulet C，Joyce D，Mohammed A，et al. Single Center Experience in the Management of Cardiogenic Shock Using Temporary Mechanical Circulatory Support Devices - Impella CP，Impella 5.0，IABP，and ECMO [J]. J Heart Lung Transplant，2019，38（4）：S437-S437.
[11] 高好考，陈根锐，程亮，等.体外膜肺氧合联合主动脉内球囊反搏在高危经皮冠状动脉介入治疗中的应用[J].中国介入心脏病学杂志，2019，27（8）：433-439.
[12] 罗明华，关怀敏，解金红，等.体外膜肺氧合联合主动脉球囊反搏支持下经皮冠状动脉介入救治高危冠心病10例总结[J].临床心血管病杂志，2019，35（7）：620-624.
[13] 杨柳青，徐芬.行体外膜肺氧合联合主动脉内球囊反搏治疗21例心脏移植患者术后的护理[J].中国临床护理，2017，9（2）：136-137.
[14] 张燕妮，李真，赵明曦，等.一例体外膜肺氧合联合应用连续肾脏替代疗法、主动脉球囊反搏及俯卧位通气救治产后心肌病患者的护理[J].中国实用护理杂志，2020， 36（3）：215-219.
[15] 黄慧卿.体外膜肺氧合联合主动脉内球囊反搏在暴发性心肌炎患者护理中的应用研究[J].中国现代医生，2016（54）：158-161.
[16] 中华医学会心血管病学分会介入心脏病学组，中国医师协会心血管内科医师分会血栓防治专业委员会，中华心血管病杂志编辑委员会．中国经皮冠状动脉介入治疗指南（2016）[J].中华心血管病杂志，2016，44（5）：382-400.
[17] 周伯颐，楼松，龙村，等.体外膜肺氧合联合主动脉内球囊反搏治疗对危重患者的影响[J].中国体外循环杂志，2018，16（1）：12-15.
[18] 陈宇，郑建勇，李寒，等.体外膜肺氧合联合主动脉内球囊反搏在高危患者经皮冠状动脉介入治疗中的应用[J].中国介入心脏病学杂志，2019，27（4）：211-215.
[19] 周伯颐.体外膜肺氧合联合其他人工生命支持装置在危重患者救治中的应用[D].北京：北京协和医学院，2017.
[20] 侯剑峰，陈凯，唐汉韡，等.体外膜肺氧合与主动脉球囊反搏联合辅助救治心血管外科术后心原性休克：阜外医院单中心十一年经验总结[J].中国循杂志，2019，34（1）：66-71.
[21] Chen K，Hou J，Tang H，et al. Concurrent initiation of intra-aortic balloon pumping with extracorporeal membrane oxygenation reduced in-hospital mortality in postcardiotomy cardiogenic shock [J]. Ann Intensive Care，2019，9（1）：1-7.
[22] 许志锋，韩振，吴永前，等.体外膜氧合联合主动脉球囊反搏及持续肾替代治疗在心脏术后心源性休克的应用[J].中国体外循环杂志，2020，18（1）：25-29.
[23] 刘婷，李晓涛.心脏手术IABP相关并发症、危险因素及预防措施分析[J].西南国防医药，2018，28（6）：16-18.
[24] 王凡凡，兰江，蔡粤，等.ECMO辅助下高危冠状动脉慢性完全闭塞性病变患者介入治疗的护理[J].中日友好医院学报，2019，33（5）：319-321.
[25] 康然，蔡伟萍.ECMO联合IABP辅助治疗高危冠心病介入治疗的护理[J].临床护理杂志，2013（3）：14-16.
2020, Vol. 17 
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