高龄患者冠状动脉旁路移植术探讨  

Operation mode of coronary artery bypass grafting for elderly patients with coronary heart disease： analysis of 22 cases

作　　者：汤楚中[1] 徐善慧[1] 李寒[1] 赵哲[1] 迟海涛[1] 解水本[1] 贝亚军[1] 张载高[1] 

机构地区：[1]中国人民解放军海军总医院心脏中心,北京100048

出　　处：《中国急救复苏与灾害医学杂志》2011年第8期713-715,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨高龄患者的冠脉旁路移植术的适当术式。方法22例冠心病患者，男16例，女6例，年龄（78．6±2．2）（70～87）岁，加拿大心绞痛分级（ccs）2～3级，NYHA心功能分级为II—IV级，需性冠脉旁路移植术。根据病情，21例接受非体外循环冠脉搭桥手术iOPCABG），1例因术前合并严重瓣膜关闭不全接受非体外循环冠脉搭桥手术，同期行二尖瓣成形术常规体外循环下冠状动脉搭桥术。结果22例手术均顺利完成，共行远端吻合口52个，平均每人（2．3±0．5）个。早期院内死亡4例，占18％，死亡原因为呼吸衰竭。结论除非有OPCAB禁忌证或同期需要进行瓣膜手；忙，对于高龄冠心病患者应尽量采用OPCAB。Objective To explore the appropriate operation mode of coronary artery bypass grafting for elderly patients with coronary heart disease. Methods Twenty-two coronary heart disease patients with Canadian Cardiovascular Society class 2-3 angina and heart function of NYHA Class Ⅱto Ⅳ16 males and 6 females, aged （78.6 ±2.2） （70-87）, underwent coronary artery bypass grafting （CABG）： 21 underwent off-pump coronary artery bypass grafting （OPCABG）, and one patient, female, aged 80, underwent conventional coronary artery bypass grafting （CCABG） because of complication of severe valvular inadequacy and need for mitral valve repair. The outcomes were observed. Results All operations were performed smoothly. Fifty-two distant anastomotic stomas were made, （2.3±0.5） for each patient. Four patients （18%） died early after operation in hospital due to respiratory failure. Conclusion OPCABG should be used as much as possible for the elderly patients with coronary heart diseases provided there is no OPCABG contradictions.

关 键 词：高龄 冠心病 冠状动脉旁路移植术 

分 类 号：R622.4[医药卫生—整形外科]