冠脉搭桥术治疗缺血性心脏病临床分析  

Clinical analysis of treating ischaemic heart disease with coronary artery bypass grafting

作　　者：刘志勇[1] 马旺扣[1] 杨丹宁[1] 陈凡[1] 王敏敏[1] 朱亚彬[1] 吴熹[1] 蒋佩明[1] 

机构地区：[1]南京铁道医学院附属医院胸心外科

出　　处：《铁道医学》1999年第1期5-6,共2页Railway Medical Journal

摘　　要：目的评价冠状动脉旁路移植术（冠脉搭桥术，ＣＡＢＧ）治疗缺血性心脏病的临床效果。方法对１０例有症状、内科药物治疗无效的冠心病患者经冠脉造影确诊后进行ＣＡＢＧ手术。所有病人均有陈旧性心梗，心功能（ＮＹＨＡ）Ｉ～ＩＶ级，术前预计平均死亡率（ＰａｒｓｏｎｎｅｔＳｃｏｒｅ）８．４％（２％～１８％）。采用大隐静脉（ＳＶｓ）及左内乳动脉（ＬＩＭＡｓ）作为移植物材料。结果本组病人手术后全部存活，无重大危及生命的并发症发生。术中平均搭桥２．８根，平均应用ＬＩＭＡ０．５根，平均体外循环（ＣＰＢ）时间１３７．６ｍｉｎ，平均主动脉阻断时间９５．０ｍｉｎ，术后辅助通气时间平均１４．０ｈ，ＩＣＵ监护平均５．５ｄ。所有病人术后心绞痛症状消失，不再服用抗心绞痛药物，生活质量明显提高。结论ＣＡＢＧ治疗冠心病有着非常好的临床效果，手术安全性高。Objective To evaluate the CABG clinical results in treating ischaemic heart disease (coronary artery disease, CAD).Methods Ten patients with CAD symptoms underwent CABG operation after coronary angiography. All patients had old myocardial infarction and cardiac function (NYHA) were between II～IV, and the average Parsonnet Score was 8.4%(2%～18%). The long saphenous veins (SVs) and left internal mammary arteries (LIMAs) were harvested as grafts.Results All patients survived after CABG operation with uneventful post-operation recovery and no severe complications happened. The average grafts were 2.8 and usage of LIMA graft was 0.5 per case.The average CPB time was 137.6 minutes and the average cross-clamping time was 95.0 minutes. The average of mechanical assistant ventilation was 14 hours and ICU stay was 5.5 days. The angina disappeared among all patients and there is no need for taking anti-angina medicine. The quality of life is remarkably improved postoperatively. Conclusions CABG is a very effective therapy in treating CAD patients with excellent clinical results. The procedure is very safe and can be accepted by most of CAD patients.

关 键 词：冠心病 冠脉搭桥术 体外循环 心肌缺血 

分 类 号：R654.2[医药卫生—外科学] R654.1[医药卫生—临床医学]