体外循环心脏不停跳与非体外循环冠状动脉搭桥术治疗冠状动脉三支病变的疗效  

Outcomes of on-pump beating heart and off-pump coronary artery bypass for patient with triple vessels disease

作　　者：李忠诚[1] Chua YL Lim SL 

机构地区：[1]苏州大学第一附属医院心胸外科,215006 [2]新加坡国立心脏中心心胸外科

出　　处：《江苏医药》2010年第15期1749-1751,共3页Jiangsu Medical Journal

基　　金：江苏省政府留学奖学金资助

摘　　要：目的探讨心肺转流(CPB)下行心脏不停跳冠状动脉搭桥术(OPBH)与非体外循环下冠状动脉搭桥术(OPCAB)治疗冠状动脉三支病变的临床效果。方法 210例单纯冠状动脉三支病变患者分为OPCAB组(105例)和OPBH组(105例),分别进行临床观察。结果 OPCAB组无一例需转成OPBH。所有患者均在心脏侧壁和后壁区域搭桥。两组人均冠状动脉远端吻合数和再血管化指数相似;手术后呼吸支持时间、胸腔引流量和输血量OPCAB组明显少于OPBH组;围手术期死亡率和并发症发生率两组比较差异无统计学意义。结论对于低左室射血分数的患者,虽然出血和输血量较大,术后呼吸支持时间、ICU停留时间较长,但OPBH能取得与OPCAB相同的疗效。Objective To compare the outcomes of on-pump beating heart（OPBH） and off-pump coronary artery bypass（OPCAB） surgery in patients with triple vessels disease.MethodsConsecutive 210 isolated multiple coronary artery bypass patients were assigned into group OPCAB（105 cases） or group OPBH（105 cases）.Results No one in group OPCAB needed to be converted into OPBH.The mean number of the distal anastomosis and the index of completeness of revascularization（ICR） were similar in both groups.The respiratory support time,chest tube drainage and blood transfusion were less in group OPCAB than those in group OPBH postoperatively.There were no significant differences in the mortality and other morbidities.Conclusion Two kinds of surgery have similar clinical results although more transfusion requirement and longer times of respiratory support and ICU stay occurred in patients with low left ventricle ejection fraction operated under OPBH.

关 键 词：冠状动脉搭桥术 心肺转流 

分 类 号：R654[医药卫生—外科学]