目的：对急性心肌梗死后心源性休克经皮冠状动脉介入及主动脉内球囊反搏治疗的术后护理效果进行分析探究。方法：选取在我院接受治疗的88例急性心肌梗死后心源性休克患者，将其平均分为实验组和对照组，对照组患者采用常规方法进行护理，实验组患者在常规护理方法的基础上给予针对性的护理措施，对比分析两组患者的护理效果和生活质量评分情况。结果：实验组患者总有效率（93．18％）明显高于对照组患者的总有效率（56．82％），且实验组患者在术后3个月、术后6个月的生活质量评分均明显高于对照组患者，差别均有统计学意义（ P＞0．05）。结论：急性心肌梗死后心源性休克经皮冠状动脉介入及主动脉内球囊反搏治疗的术后护理效果显著，明显缓解了患者的临床症状，提高了患者的生活质量，可以广泛应用。

Objective:To explore the postoperative nursing and nursing efficacy of percutaneous coro-nary intervention (PCI) and intra aortic balloon pumping (IABP)for patients with cardiogenic shock (CGS) after suffering acute cerebral infarction .Method:88 patients with cardiogenic shock ( CGS) after suffering a-cute cerebral infarction who were treated in our hospital were selected and divided them into experimental group and control group equally ,the control group received conventional nursing ,experimental group added target nursing based on control group ,clinical nursing efficacy and life quality score of two groups were com-paratively analyzed .Result:The total effective rate of experimental group ( 93.18%) was significantly higher than control group (56.82%),and the life quality score of experimental group after 3 months,6 months of treatment were respecitvely higher than control group ,differences betweent two groups were statistically signif-icant ( P>0.05) .Conclusion:Applyi

目的探讨体外膜肺氧合治疗和/或主动脉内球囊反搏对急性冠状动脉左主干病变的临床疗效。方法回顾性分析3例急性冠状动脉左主干病变患者,及时行体外膜肺氧合治疗和/或主动脉内球囊反搏治疗的临床资料。结果 3例患者均完成冠脉造影检查,并行血运重建术(1例行经皮冠状动脉血管成形术及支架术,1例行冠状动脉成形术并冠状动脉旁路移植术,1例行冠状动脉旁路移植术)。2例患者症状得到明显改善,救治成功,顺利出院。术后随访6-24个月,均无胸部不适症状,可耐受正常活动。另1例死亡。结论体外膜肺氧合治疗和/或主动脉内球囊反搏在治疗冠状动脉左主干病变中发挥重大作用。

Objective To evaluate the effect of extracorporeal membrane oxygenation (ECMO) combined with intraaortic balloon coun-terpulsation (IABP) on patients with acute left main coronary artery disease. Methods 3 patients suffered from acute left main coronary ar-tery disease and timely supported by ECMO combined with or without IABP were reviewed. Results With the assistance of ECMO and/or IABP, all of the 3 patients had successfully undergone coronary angiography and coronary revascularization. The first case was performed percutaneous transluminal coronary angioplasty (PTCA) with stents placement;the second was performed coronary artery bypass grafting (CABG);the third case was performed PTCA and CABG. All patients were weaned off ECMO. 2 patients were discharged, whereas the oth-er one died 1 month after CABG. After 6~24 months follow-up, 2 survivors had good quality of life. Conclusion Efficient ECMO support with or without IABP might offer opportunities for the following revascularizati

主动脉内球囊反搏泵（IABP）是心血管内、外科抢救的重要设备之一，但其不同部门使用频率不同，需要在院内合理配置总量。通过从住院病历收集使用数据，进行统计分析，提出了心血管病专科医院配置IABP的原则，为专科医院配置该设备提供了有益的思路和依据。

IABP (Intra-aortic Balloon Pump), as one kind of the important medical devices applied in cardiovascular emergency surgeries, needed to be well allocated according to its diverse use frequencies in different departments in specialized hospitals. Statistical analysis of the use data collected from in-patient medical records was made in this paper. Based on this, the principles of allocation of IABP in the cardiovascular hospital were raised, which offered helpful perspectives and supportive references for specialized hospitals in allocation of IABP.

目的探讨早期主动脉内球囊反搏（IABP）植入在急性心肌梗死（AMI）合并心源性休克（CS）患者救治中的价值。方法140例主动脉内球囊反搏联合急诊经皮管状动脉介入治疗（PCI）治疗的AMI合并CS患者，按照发生CS至IABP入的时间，分为：A组为CS至IABP辅助治疗时间（3h，B组为〉3h；观察指标为靶血管、冠脉病变情况等，并记录总IABP辅助时间，死亡、急性呼吸衰竭、急性肾功能衰竭等临床事件。结果两组间基线情况、靶血管病变、静脉用药等无统计学差异；A组三支病变比率、无复流发生率低于B组，但无统计学差异；A组总IABP辅助时间、全因病死率低于B组，有统计学差异，P〈0．05；A组心源性死亡、急性呼吸发生率、急性肾衰发生率均低于B组，但无统计学差异。结论在AMI合并CS的患者尽早应用1ABP联合血运重建可能有助于改善生存率。

Objective To investigate the effect of early Intra-aortic balloon pumping (IABP) support combined emergency intervention in patients of acute myocardial infarction (AMI) complicated with cardiac Shock (CS). Methods Clinical data of AMI complicated with cardiac shock in 140 cases of IABP combine with emergency percutaneous coronary intervention (PCI) admitted in Navy General Hospital of the PLA in between January 2011 and December 2012 were collected and divided into two groups according to the time from CS to IABP. The time interval in group A (n=61) was less than 3 hours and group B (n=79) were more than 3 hours. The target coronary artery, the number of culprit vessel, the total time of IABP treatment, hospital mortality, acute respiratory failure, acute renal failure were observed. Results No statistical significance in the rates of triple vessel disease, no-reflow, cardiogenic death, acute respiratory failure and acute renal failure was found between the two groups even although th

目的评价左冠脉主干狭窄患者择期非体外循环冠脉搭桥手术术前在应用低分子肝素的基础上合用氯吡格雷的安全性及有效性。方法对228例左冠脉主干病变施行择期非体外循环冠脉搭桥的患者进行回顾性分析。根据术前5 d内是否停用氯吡格雷,将患者分为双联抗栓组及单纯应用低分子肝素组。比较2组患者术前不良心血管事件的发生（死亡、不稳定心绞痛、急性心肌梗死）、主动脉球囊反搏使用,及术后出血的发生情况。结果双联抗栓组术前不良心血管事件发生率显著低于低分子肝素组,前者术后出血量和输血量略多于后者,但2组之间主动脉球囊反搏使用、术后消化道出血、脑出血、开胸止血发生率、正性肌力药的使用、监护时间差异无统计学意义（P〉0.05）。结论对于左冠脉主干狭窄拟行择期CABG术患者,在应用低分子肝素抗凝的基础上,术前5 d内继续应用氯吡格雷与降低术前心血管事件呈相关性,且不增加严重出血风险。

Objective To evaluate the safety and effect of applying LMWH ( low molecular weight heparin ) with clopidogrel before elective off-pump coronary artery bypass grafting in left main disease .Methods Retrospective analysis of the 228 patients of left main coronary stenosis cases undertaking elective off-pump coronary bypass grafting .All patients were divided into clopidogrel group ( combined with LMWH ) and pure LMWH group ( applying LMWH only ) .Compare the adverse cardiovascular events ( death,unstable angina pectoris ,acute myocardial infarction ) ,and the post operation hemorrhage in both groups.Results In clopidogrel group,the occurrence rate of adverse cardiovascular events was remarkably lower ,while the postoperative bleeding amount and transfusion amount were a little more than those in LMWH group .There were no obvious differences on intra-aortic balloon pump using ,gastrointestinal bleeding ,cerebral hemorrhage ,thoracotomy hemostasis rate ,the using of positive inotropic dru