非体外循环冠状动脉旁路移植术在低射血分数患者中的应用体会  

Application experience of off-pump coronary artery bypass grafting in patients with low ejection fraction

作　　者：王洋[1] 李强[1] 李春晖[1] 李亚林[1] 赵林林[1] 

机构地区：[1]辽宁省人民医院心外科,辽宁沈阳110016

出　　处：《中国医药导报》2009年第13期252-253,共2页China Medical Herald

摘　　要：目的:总结对低射血分数(EF≤35%)冠心病患者进行的非体外循环冠状动脉旁路移植术(OPCABG)的临床体会。方法:回顾性分析我院2000年9月～2008年12月对18例射血分数≤35%的冠心病患者进行的OPCABG手术的临床资料、手术结果,总结围术期临床治疗体会。结果:其中16例完成了OPCABG术,2例中途改为体外循环辅助且心脏不停跳下完成CABG;18例患者行旁路移植2～5支,平均(3.10±0.5)支;18例均使用主动脉内球囊反搏,其中,16例是在未开胸前安放,2例是在术中安放。围术期死亡4例,死亡率为22.2%。结论:低射血分数(EF≤35%)的冠心病患者实施OPCABG术有良好的可行性和效果,IABP的应用、尽可能地完全再血管化、围术期正确的管理是确保手术治疗效果的关键,而长期预后仍有待进一步观察。Objective： To summarize the low ejection fraction （EF≤35%） of coronary heart disease in patients with offpump coronary artery bypass grafting （OPCABG） clinical experience. Methods： Retrospective analysis of our hospital during September 2000 to December 2008, 18 cases of ejection fraction≤ 35% of patients with coronary heart disease, clinical data OPCABG surgery, surgical results, the aggregate perioperative clinical treatment. Results： The results of which 16 cases completed OPCABG surgery, two cases of half-way but changed to off-pump beating heart assisted the completion of CABG, 18 patients bypass line 2-5[an average of （3.10±0.5） sticks], 18 cases used aortic balloon pump, of which 16 cases did not open chest in place, in 2 cases during installation. Perioperative death of 4 cases, the mortality rate was 22.2%. Conclusion： Low ejection fraction（EF≤ 35%） of coronary heart disease OPCABG surgery patients have a good feasibility and effectiveness, IABP application, as far as possible the complete revascularization, perioperative management is key to ensure the correct surgical treatment effect, the long-term prognosis remains to be further observed.

关 键 词：冠状动脉旁路移植术 非体外循环 低射血分数 

分 类 号：R541[医药卫生—心血管疾病]