65岁以上老年冠心病患者大隐静脉与桡动脉取材的对比研究  

Comparative study of harvesting of radial artery and great saphenous vein in patients aged 65 years and older with coronary heart disease

作　　者：陈绪军[1] 陈鑫[1] 张永[3] 石开虎[1] 徐明[1] 孟凡荣[2] 汪黎明[1] 

机构地区：[1]南京医科大学附属南京第一医院南京市心血管病研究所胸心血管外科,210006 [2]南京医科大学附属南京第一医院南京市心血管病研究所超声科,210006 [3]北京军区总医院心肺血管中心心外科

出　　处：《中华医学杂志》2009年第23期1623-1626,共4页National Medical Journal of China

基　　金：江苏省“333工程”项目

摘　　要：目的比较在65岁以上老年患者冠状动脉旁路移植术（CABG）中提取桡动脉（RA）与大隐静脉（SVG）差异，以便进一步探讨65岁以上老年人应用RA的优越性。方法从2004年1月至2008年6月，对171例65岁以上老年患者实施冠状动脉旁路移植术（CABG）时同时采集左乳内动脉（LIMA）、RA与SVG，比较RA与SVG取材时间、血管的长度及术中桥血流，术后并发症的发生率，并密切随访。结果共取材SVG与RA各171支。人平均远端吻合口数为3．2±0．4。RA与SVG取材时间、取材的长度、术中桥血流分别差异均无统计学意义[（29±10）min vs（28±8）min，（18．2±1．5）cm vs（21．3±5．7）cm，（41±19）ml/min vs（34±9）ml／min，均P〉0．05]，但术后切口愈合时间、切口感染、切口血肿、切口渗液、切口感觉异常、肢体肿胀感的发生率低于大隐静脉，在差异有统计学意义（P〈0．05）。结论65岁以上老年CABG患者中采集RA优于采集SVG，RA可望在老年CABG患者术中发挥重要的作用。Objective To investigate the difference between autologous radial artery （RA） and great saphenous vein （GSV） harvesting in the elderly aged 65 years and older in coronary artery bypass grafting. Methods 171 patients aged 65 years and older underwent CABG with left internal mammary artery （LIMA）, RA and GSV harvesting between January 2004 and June 2008. The harvesting time, length of conduits, intraoperative graft flow and harvest-site complications between RA and GSV was observed and follow-up was performed. Results A total of 171 RA and 171 GSV grafts were collected. The mean number of distal anastamoses was 3.20 ±0. 35. There was no significant difference in harvesting time, length of conduits and intraoperative graft flow between RA and GSV（29 ±10 min vs 28 ±8 min,18.2 cm ± 1.5 cm vs 21.3 cm± 5.7 cm and 41 ml/min ±19 ml/min vs 34 ml/min ± 9 ml/min, P 〉 0.05）,however, postoperatively, the length of wound healing and the incidence of infection, hematoma, exudation, paresthesia and tumescence of wound in RA was obviously lower than those in GSV（ P 〈 0. 05 ）. Conclusions Harvesting of RA in the elderly aged 65 years and older was superior to that of SVG and RA might play an more important role in CABG in the elderly.

关 键 词：冠状动脉分流术 隐静脉 桡动脉 老年人 

分 类 号：R686[医药卫生—骨科学]