非体外循环下冠状动脉旁路移植术的临床评价  

Clinical value of off-pumping coronary artery bypass graft treating coronary artery diseases.

作　　者：王洪斌[1] 刘志勇[1] 杨丹宁[1] 李旭东[1] 朱亚彬[1] 王玉华[1] 李鸿雁[1] 堵俊杰[1] 周建民[1] 

机构地区：[1]东南大学附属中大医院心胸外科,江苏南京210009

出　　处：《东南大学学报（医学版）》2005年第6期407-409,共3页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:比较非体外循环(off-pump)冠状动脉旁路移植术(CABG)和常规体外循环(on-pump)CABG的早期结果,评价它们在临床中的应用。方法:收集近年来在本院治疗的102例冠心病患者的资料,根据手术方法分两组,其中A组(39例)在体外循环下完成CABG,B组(63例)行非体外循环CABG,比较两组术前合并症、手术风险、术后并发症及死亡率。结果:两组术前年龄、血管病变支数、手术风险评分等相比较无显著性差异;A组术前左心室射血分数值明显低于B组(P<0.01);B组中有4例术中转为体外循环手术;术后A组死亡率偏高(18%),但与B组(4.8%)相比无显著性差异;术后并发症两组无显著性差异。结论:非体外循环CABG适合大多数冠心病患者,与体外循环下手术相比,并不增加手术风险。Objective To compare the early clinical outcomes of the off-pump and the on-pump coronary artery bypass grafting （CABG） and to evaluate their applications in clinic.Methods Data were collected of 102 coronary artery disease patients from our hospital between May 1997 and May 2004. The patients were divided into 2 groups according to the method of operation. 39 patients in group A were operated using the cardiopulmonary bypass （CPB） technique （on-pump）, and 63 patients in group B using off-pump technique. The characteristics of patients preoperative and Parsonnet risk score were compared between the 2 group. Postoperative morbidity and mortality were also compared between them. Results There were no significant difference in ages, the numbers of diseased vessels and Parsonnet scores between two groups before operation. The LVEF scores of patients in group A was significantly lower compared with that in group B. In group B, 4 patients converted to on- pump CABG during the operation. The postoperative mortality in group A was high （18%）, without significant difference compared with group B（4.8% ）. The morbidity of postoperative between two groups had no significant difference.Conclusion Off-pump technique applies for almost all patients in need of CABG, which enhances no operative risk compared with onpump CABG.

关 键 词：非体外循环 体外循环 冠状动脉旁路移植术 冠状动脉硬化性心脏病 

分 类 号：R654.2[医药卫生—外科学]