非体外循环冠状动脉旁路移植术后效果的随访分析  

Evaluation of clinical follow-up outcome in off-pump coronary artery bypass grafting

作　　者：张冬成[1] 郭琳锐[1] 林清文[1] 俞晓立[1] 于涛[1] 

机构地区：[1]广州医学院第二附属医院(广州心血管疾病研究所)心外科,广东广州510260

出　　处：《中国现代医学杂志》2010年第24期3802-3804,3808,共4页China Journal of Modern Medicine

摘　　要：目的探讨非体外循环心脏不停跳冠状动脉搭桥术的早期和远期临床效果。方法自2000年7月～2004年12月,128例冠心病患者接受冠状动脉搭桥手术,按手术方式分为非体外循环组(n=56)和传统体外循环组(n=72)。将两组患者的术前临床资料、手术方式、术后早期及5年以上远期随访结果等进行对比分析。结果两组术前临床资料差异无显著性。非体外循环组手术时间、术后出血输血量、呼吸机辅助时间显著少于体外循环组,两组搭桥数、住院天数均差异无显著性。两组平均随访6.2年,随访率81%。非体外循环组术后心绞痛再发生率、血管桥通畅率和远期死亡率与体外循环组相比差异无显著性,大部分患者恢复正常生活。结论非体外循环冠状动脉搭桥术是安全可行的,术后早期及远期疗效满意。【Objective】To evaluate the safety and follow-up effect of off-pump coronary bypass surgery.【Methods】From July 2000 to December 2004,coronary artery bypass was performed on 128 patients,with off pump technique on 56 patients（Group OPCAB） and cardiopulmonary bypass on 72 patients（Group Control）.The clinical data between the two groups were statistically analyzed.【Results】The preoperative clinical data in both groups were no significantly difference.The times of operation and postoperative respirator support in Group OPCAB were significantly shorter than in Group Control（P〈0.01）.Haemorrhage and blood transfusion was significantly less than in Group Control（P〈0.05）.Cardiac arrhythmias occurred significantly less in Group OPCAB than in Group Control（P〈0.001）.81% discharged patients were follow-up average 8.2 years.There were not significantly differences in re-angina,the rate of unobstructed graft and mortality between the two groups.Their cardiac function was significantly improved.【Conclusions】Off-pump coronary bypass surgery is a safe and effective means of revascularization,with less postoperative complication.

关 键 词：冠状动脉搭桥术 非体外循环 体外循环 疗效 

分 类 号：R654.2[医药卫生—外科学]