60岁以上非体外循环下冠状动脉旁路移植术患者移植血管流量特点分析  

Analysis on Graft Blood Flow After Off-Pump Coronary Artery Bypass Grafting in Patients over 60 Years

作　　者：崔仲奇[1] 杨碧波[1] 刁国华[1] 马旭东[1] 

机构地区：[1]北京大学第三医院心脏外科,北京100083

出　　处：《中国微创外科杂志》2008年第2期131-133,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的为60岁以上非体外循环下冠状动脉旁路移植术(off-pump coronary artery bypass graft,OPCABG)患者合理评价手术效果提供临床依据。方法利用瞬时血流测定技术(transit time flow measurement,TTFM)对109例60岁以上(含60岁)及50例<60岁OPCABG患者移植血管进行测量,并记录平均流量(mean flow,Qm)及搏动指数(pulsatility index,PI)。结果60岁以上组乳内动脉Qm(37.4±28.1)ml/min,PI3.4±1.4(n=75),大隐静脉Qm(34.7±20.4)ml/min,PI3.7±2.4(n=259);60岁以下组乳内动脉Qm(41.5±23.6)ml/min,PI3.2±1.0(n=46),大隐静脉Qm(36.6±25.8)ml/min,PI3.4±1.7(n=123)。两组无显著性差异(P>0.05)。但60岁以上组低Qm(<20ml/min)比例明显高于60岁以下组[乳内动脉13%(10/75)vs2%(1/46),大隐静脉13%(33/259)vs6%(7/123),χ2=4.296、4.422,P<0.05],高PI(>5)的比例也明显高于60岁以下组[乳内动脉15%(11/75)vs2%(1/46),大隐静脉14%(35/259)vs5%(6/123),χ2=4.981、6.491,P<0.05]。结论对60岁以上OPCABG患者的移植血管,尤其应当根据流量测定和患者伴随疾病及血管条件综合判断。Objective To evaluate the effectiveness of off-pump coronary artery bypass grafting (OPCABG) in patients over 60 years. Methods Transit time flow measurement (TTFM) was employed to determine the graft blood flow in 109 patients over 60 years and 50 patients younger than 60 years after OPCABG.The mean flow (Qm) and pulsatiligy index (PI) were recorded. Results In the patients over 60 years, the Qm of the internal mammary artery (IMA, n=75) and great saphenous vein (GSV, n=259) was (37.4±28.1) ml/min and (34....

关 键 词：老年 冠状动脉旁路移植术 非体外循环 瞬时超声血流测量 

分 类 号：R654[医药卫生—外科学]