左胸小切口与胸骨正中切口冠状动脉搭桥术的比较  

Comparison of left minimal incision and median sternotomy in coronary artery bypass graft surgery

作　　者：王振国[1] 于洪泉[1] 邓三明[1] 杨学永[1] 王韬渊[1] 刘旭[1] 杨晔[2] 

机构地区：[1]武警医学院附属医院心胸外科 [2]第四军医大学唐都医院胸外科,西安710032

出　　处：《医学研究生学报》2011年第5期510-512,共3页Journal of Medical Postgraduates

摘　　要：目的由于近年来微创手术观念和方法的普及与应用,小切口非心肺转流术受到人们的关注。文中比较微创左胸小切口与传统胸骨正中切口冠状动脉搭桥术的优缺点。方法选取2006年3月至2008年3月期间66例冠心病经左胸微创小切口实施非心肺转流左乳内动脉前降支搭桥术,对42例冠心病经传统正中切口行非心肺转流左乳内动脉前降支搭桥术。比较术前基本情况、手术切口长度、伤口感染情况与住院时间,术后第1、2、3周及术后1、2、3、6月进行随访。结果左胸小切口组与胸骨正中切口组均无手术死亡、术后出血、心绞痛症状,仅胸骨正中切口组出现1例收口感染,其余无伤口感染裂开。左胸小切口组较胸骨正中切口组手术切口小,住院时间短。随访半年无绞痛等症状发生。结论左胸微创小切口非心肺转流冠状动脉搭桥术安全、可靠,近期临床效果显著,适用于单支血管病变或联合经皮冠状动脉支架术治疗重症冠心病。Objective With the popularization of the concept and methods of minimally invasive surgery,coronary artery bypass graft(CABG) is receiving more and more attention.The aim of this study is to evaluate minimally invasive left small incision in comparison with traditional median sternotomy in CABG.Methods Sixty-six patients underwent left minimal incision CABG,and another 42 received traditional CABG with full median sternotomy.Comparisons were made between the two groups in term of the length of incision,incision infection and hospital stay time.The patients were followed up at 1 week,2 weeks,3 weeks,1 month,2 months,3 months and 6 months after surgery.Results No operation death,post-operative bleeding and angina were found in either of the two groups,except 1 case of incision infection in the traditional CABG group.Compared with traditional CABG,left minimally invasive CABG had a smaller incision and shorter hospital stay.All the patients remained free of cardiac accident during the six-month follow-up.Conclusion Left minimal incision CABG surgery is a safe and reliable procedure with obvious immediate clinical effect,suitable for the treatment of both single vascular lesion and severe complex multiple vessel disease.

关 键 词：微创冠脉搭桥术 左侧胸部小切口 非心肺转流 

分 类 号：R[医药卫生]