升主动脉No-touch技术在冠心病手术中的应用  

No-touch aorta technique in coronary surgery

作　　者：田小丰[1] 方良伟[1] 王亚勤[1] 胡海波[1] 朱大伟[1] 胡国栋[1] 

机构地区：[1]江苏省淮安市第二人民医院心胸外科,江苏淮安223002

出　　处：《实用临床医药杂志》2011年第19期68-69,72,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨和评价升主动脉不接触技术（No—touch）在冠状动脉旁路移植手术中的应用。方法回顾5例合并升主动脉粥样硬化冠心病患者的临床资料，男3例，女2例，年龄68--76岁，平均70．2岁。5例均采用常规胸骨正中切口行非体外循环下冠脉搭桥（OPCABG）。2例行双侧乳内动脉原位移植，3例以左乳内动脉为唯一的供血来源，大隐静脉近端与左乳内动脉端侧吻合。所有患者未在升主动脉上进行任何操作。结果5例患者共移植血管13支，全组手术均顺利完成，痊愈出院，无院内死亡。手术后所有忠者心绞痛均消失，心功能改善I～II级。无围术期心肌梗死和神经系统并发症发生。结论对合并升主动脉粥样硬化的冠心病患者，采用OPCABG结合升主动脉不接触（No—touch）技术，可使病变冠脉完全再血管化，降低术后脑卒中的发生率，临床效果满意。Objective To evaluate the ascending aorta and the no - contact technique （No - touch） in coronary artery bypass graft surgery. Methods Clinical data of coronary heart disease five patients with ascending aortic atherosclerosis were retrospectively analyzed. Patients included three males and two females, aged 68 to 76 years, and the average age of 70.2 years. All five cases had median sternotomy incision using off- pump coronary artery bypass grafting （OPCABG）. Two patients had bilateral internal mammary artery in situ graft, and three patients had left internal mammary artery as the only source of blood supply. The proximal saphenous vein tallied left internal mammary artery end to side anastomosis. All patients did not have any other operations on the ascending aorta. Results Five patients used 13 grafts, and the whole operations were completed successfully and discharged from hospital with no death. Angina in all patients after surgery disappeared ,and heart function improved to grade I - II. No perioperative myocardial infarction and neurological complications occurred. Conclusion Combining aortic atherosclerosis in patients with coronary heart discase and the use of no contact OPCABG with the ascending aorta （No- touch） technology enable complete revascularization of coronary lesions, reduce the incidence of stroke after surgery, and improve clinical satisfaction.

关 键 词：升主动脉粥样硬化 非体外循环冠状动脉旁路移植术 升主动脉不接触技术 

分 类 号：R541.4[医药卫生—心血管疾病]