体外循环不停跳冠脉搭桥术治疗重症冠心病的应用  

Application of On-pump Coronary Artery Bypass Grafting in the Treatment of Patient with Severe Coronary Artery Disease

作　　者：黄浩[1] 高伟[1] 冯新海[1] 席耀民[1] 

机构地区：[1]新疆医科大学附属中医医院心胸外科,新疆乌鲁木齐830000

出　　处：《医学信息》2010年第15期2865-2866,共2页Journal of Medical Information

摘　　要：目的观察体外循环辅助心脏不停跳冠脉搭桥术（OPCABG）治疗重症冠心病的效果。方法选择42例左室射血分数（LVEF）〈0.30的重症冠心病患者,采用体外循环辅助心脏不停跳冠脉搭桥术。其中男性36例,女性6例;术前超声心动图检查提示：LVEF在0.18～0.30,平均（0.26±0.03）之间。左心室舒张末期内径（LVDD）52～76（61.3±4.2）mm。观察手术情况、比较术前与术后早期的心功能情况。结果 42例患者平均远端吻合口数目为（3.5±1.3）个,使用主动脉内球囊反搏泵（IABP）6例;住院死亡2例;术后2周、3个月的LVEF、LVDD较术前显著改善。结论重症冠心病患者（EF〈0.30）实施体外循环辅助心脏不停跳冠脉搭桥术能避免缺血损害,能完全再血管化,降低手术风险,有良好的近期效果。Objective To observe the effect of on-pump coronary artery bypass grafting（OPCAB） in the treatment of patients with severe coronary artery disease.Methods OPCAB was adopted in 42 patients with severe coronary disease with left ventricular ejection fraction（LVEF） less than 0.3,whose mean left ventricular ejection fraction was（0.26±0.03）,36 of male,6 of female.Preoperative echocardiographic examinations revealed the mean of left ventricular diastolic dimension（LVDD） was（61.3±4.2） mm.Results In 42 patients,OPCAB surgery were performed.The mean number of distal anastomotic stoma was 3.5±1.3,Intra-aortic balloon pump was used in 6 patients,all balloons were inserted at operations.Two patients died in hospital.LVEF and LVDD were significantly improved 2 weeks or 3months after operation.Conclusion OPCAB has a good short-term favorite effect in patients with low ejection fraction,and could obviously decrease the risk of the surgery and anaesthesia.

关 键 词：体外循环 冠脉搭桥术 心脏不停跳 左心功能低下 

分 类 号：R654.2[医药卫生—外科学]