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【PPT】主动脉内球囊反搏(IABP)

  • 2026-11-08 00:17:49
【PPT】主动脉内球囊反搏(IABP)
适应症
1、急性心肌梗死合并心源性休克（最经典指征，用于稳定血流动力学、为血运重建争取时间）
2、AMI 并发机械并发症：室间隔穿孔、乳头肌/腱索断裂致急性二尖瓣反流、游离壁破裂等——作为外科术前过渡（此类患者 IABP 证据最充分，指南推荐级别也最高）
3、难治性不稳定型心绞痛：强化药物治疗仍反复缺血，拟行血运重建者
4、高危 PCI 的预防性支持：左主干病变、严重多支病变、重度左心功能不全等血流动力学不稳定风险高者
5、PCI 失败需过渡到外科搭桥者，6、心脏术后低心排综合征、脱离体外循环困难
7、暴发性心肌炎（病毒性、特发性）等急性泵衰竭，常与 ECMO 联合（“ECMO+IABP” 联合辅助）
8、终末期心衰/心肌病晚期：作为等待心脏移植或植入 LVAD 的过渡
9、高危非心脏手术或 TAVR 等介入操作的围术期循环支持10、难治性室性心律失常伴血流动力学不稳定（辅助稳定血流）
绝对禁忌症
禁忌症
原因
主动脉夹层（累及降主动脉）、主动脉瘤、主动脉窦瘤破裂
球囊充气可致瘤体/夹层破裂
中重度主动脉瓣关闭不全
舒张期反流会被球囊加重，反搏反而恶化血流动力学
严重主动脉-髂动脉病变（钙化、狭窄、闭塞）
导管无法置入或损伤血管
凝血功能障碍（抗凝禁忌）
需系统肝素化，出血风险不可控
脑出血急性期
需全身抗凝，可致出血加重
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  1. CONNECT:[ UseTime:0.000512s ] mysql:host=172.18.0.4;port=3306;dbname=h_sjds;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000717s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000487s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000329s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000524s ]
  6. SELECT * FROM `set` [ RunTime:0.000298s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000721s ]
  8. SELECT * FROM `article` WHERE `id` = 568405 LIMIT 1 [ RunTime:0.000334s ]
  9. UPDATE `article` SET `lasttime` = 1794162579 WHERE `id` = 568405 [ RunTime:0.001317s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 64 LIMIT 1 [ RunTime:0.000550s ]
  11. SELECT * FROM `article` WHERE `id` < 568405 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000502s ]
  12. SELECT * FROM `article` WHERE `id` > 568405 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.000372s ]
  13. SELECT * FROM `article` WHERE `id` < 568405 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.000597s ]
  14. SELECT * FROM `article` WHERE `id` < 568405 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.000679s ]
  15. SELECT * FROM `article` WHERE `id` < 568405 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.000554s ]
0.085680s