不停跳搭桥与传统体外循环下搭桥手术的临床疗效分析  

Analysis of the outcomes after off-pump versus conventional coronary artery bypass grafting.

作　　者：肖亦敏[1] 肖明第[1] 吕志前[1] 卢成宝[1] 袁忠祥[1] 徐根兴[1] 

机构地区：[1]上海交通大学附属第一人民医院心外科,200080

出　　处：《中国医药》2007年第11期648-650,共3页China Medicine

摘　　要：目的探讨不停跳搭桥(OPCAB)与传统体外循环下搭桥(CABG)的近期及中期效果。方法1268例行单纯搭桥手术的患者,其中传统体外循环下搭桥722例,为CABG组;不停跳搭桥546例,为OPCAB组。结果CABG组围手术期输血量(1194±1405)ml,术后并发症73例(10.1%),死亡23例(3.2%);OPCAB组围手术期输血量(876±1486)ml,术后并发症29例(5.3%),死亡10例(1.8%),2组比较有统计学意义(P<0.05)。CABG组随访441例(61%),平均随访时间(8.3±2.9)月,术后6个月CSS心绞痛分级为(1.4±0.6)级;OPCAB组随访371例(68%),平均随访时间(7.9±3.1)月,术后6个月CSS心绞痛分级为(1.6±0.8)级。2组比较无统计学意义(P>0.05)。结论OPCAB与传统CABG相比近期时机体损伤小,并发症少,病死率低,术后恢复快;中期效果OPCAB、与传统CABG相比,心绞痛改善相似,死亡事件无差异,对生活质量均有改善,差异无统计学意义。Objective We reviewed the data of off-pump coronary artery bypass grafting （OPCAB） and conventional coronary artery bypass grafting （cCABG） with extracorporeal circulation, to compare the outcomes of these two kinds of operation. Methods 1268 patients underwent coronary artery bypass grafting were divided into 2 groups. 722 patients received cCABG were in one group as CABG group. 546 patients received OPCAB were in the other group as OPCAB group. Results Average volume of blood transfusion in CABG group was （ 1194 ± 1405） ml. 73 （10. 1% ） patients had complications. 23 （3.2%） patients died. Average volume of blood transfusion in OPCAB group was （ 876 ± 1486 ） ml. 44 （ 8. 1% ） patients had complications. 10 （ 1.8% ） patients died. Statistical significance of the difference between 2 groups was obtained（P 〈0. 05）, We followed-up 441 patients（61% ） in CABG group for （8.3 ±2.9） months and 371 patients（68% ） in OPCAB group for （7.9 ±3. 1 ） months. After 6 months the patients in CABG group had angina in grade 1.4 ±0. 6（ CSS）, the patients in OPCAB group had angina in grade 1.6 ± 0. 8 （CSS）. Conclusion OPCAB has less injury, less complication, less death than cCABG in recent outcomes. There is no significant difference in midterm outcomes between OPCAB and cCABG.

关 键 词：冠心病 冠状动脉搭桥术 不停跳搭桥术 体外循环 

分 类 号：R541.4[医药卫生—心血管疾病]