经降主动脉-冠状动脉旁路移植治疗老年人冠心病的临床观察  

Clinical observation of elderly patients with coronary heart disease undergoing coronary artery bypass grafting through descending thoracic aorta

作　　者：王志维[1] 程邦昌[1] 吴智勇[1] 康敢军[1] 涂仲凡[1] 高尚志[1] 

机构地区：[1]武汉大学人民医院心血管外科,430060

出　　处：《中华老年医学杂志》2006年第2期97-99,共3页Chinese Journal of Geriatrics

基　　金：湖北省科技攻关基金(2003AA301C18)

摘　　要：目的分析经降主动脉-冠状动脉旁路移植术对老年人冠心病的手术疗效。方法对13例多支冠状动脉病变的70～82岁老年冠心病患者在胸腔镜下游离乳内动脉,左侧小切口开胸,非体外循环下实施冠状动脉旁路移植术。术中联合应用降主动脉“Y”形血管桥吻合、小切口、胸腔镜辅助等微创技术。结果全组无死亡。术后机械辅助呼吸平均(6.9±0.9)h。ICU 滞留时间平均(2.5±0.5)d。全组均未输血。术后随访3～14个月,心绞痛症状均消失,活动量增加。结论联合应用降主动脉“Y”形血管桥吻合、小切口、胸腔镜辅助等多种微创技术实施冠状动脉旁路移植,对于多支病变的老年冠心病患者是一项安全、有效的手术方式。Objective To investigate the clinical effectiveness of coronary artery bypass grafting through descending thoracic aorta in elderly patients with coronary heast disease and to decrease the post-operative complication. Methods Thirteen elderly patients underwent coronary bypass surgery with minimally invasive direct coronary artery bypass（MIDCAB）. Age range from 70 to 82 years with a mean of（72.1±6.0）years. Patients suffered from multi vessel disease. Many minimally invasive techniques of ＂ Y＂ blood vessel graft anastomosis, anastomosis of blood vessel graft to descending aorta, minimally invasive direct, thoracoscope assist were used. Results All patients were survived. The mean duration of intubation was （6.9±4-0.9）hours. The average ICU stay was （2.5±0.5）days. No patients received blood transfusion. During the short-term follow-up（3 to 14 months）patients had no complaint of angina. Conclusions The technique of＂Y＂blood vessel graft anastomosis, descending aorta blood vessel graft, minimally invasive direct and thoracoscope assist in combination with coronary artery bypass grafting is a safe and cost-effective new procedure for elderly patients with multi-coronary artery disease.

关 键 词：冠状动脉旁路移植术 非体外循环 冠状动脉疾病 胸腔镜 主动脉 胸 

分 类 号：R654.2[医药卫生—外科学] R541.4[医药卫生—临床医学]