“一站式”复合技术(Hybrid)在冠心病中的应用研究  

"One-stop" composite technology(Hybrid) application in coronary heart disease research

作　　者：刘晓明[1] 刘季春[1] 周学亮[1] 喻本桐[1] 吴起才[1] 万力[1] 

机构地区：[1]南昌大学第一附属医院,南昌333000

出　　处：《山东医药》2012年第33期41-43,共3页Shandong Medical Journal

基　　金：江西省科技厅资助项目(2009BSB11207)

摘　　要：目的总结应用"一站式"复合技术(Hybrid)治疗8例冠心病的临床疗效。方法 8例冠心病患者用hy-brid技术进行心肌再血管化,所有患者术前肺功能检查结果基本正常,其中合并高血压6例、糖尿病4例、陈旧性心肌梗死5例、肾功能不全2例、心功能不全3例。术前冠状动脉造影提示左前降支存在75%～100%狭窄,同时伴有右冠状动脉或左回旋支70%～98%狭窄。心脏彩超提示左室射血分数0.41～0.62(0.55±0.16)。结果全组无死亡、出血、脑卒中、心律失常、心肌梗死、伤口感染等并发症。心脏不停跳下冠状动脉旁路移植术手术时间1.6～2.7(1.7±0.9)h;气管插管时间5～13(7.8±2.9)h;胸腔24 h引流量为65～410(213.4±189.3)mL;ICU滞留时间1～2(1.4±0.5)d;术后住院5～9(5.7±1.9)d。随访0.7～2.7年,无远期死亡和心肌梗死,无再次手术。结论"一站式"复合技术(Hybrid)治疗多支冠状动脉病变是一项安全、有效的手术方式,其远期疗效仍有待于更多的临床应用和临床试验加以验证。Objective To evaluate the feasibility, safety, and clinical outcomes of the hybrid coronary artery bypass grafting surgery in 8 patients. Methods Hybrid coronary artery bypass grafting surgery was performed in 8 patients, combined with hypertension in 6 cases, diabetes mellitus in 4 cases, remote myocardial infarction in 5 cases, renal insufficiency in 2 cases, and cardiac insufficiency in 3 cases. Preoperative coronary angiography prompted the stenosis of left anterior descending artery （LAD） was 75% - 100% , accompanied by 70% -98% stenosis of RCA or left circumflex artery. Cardiac ultrasonography tip of left ventricular ejection fraction was 0.41 to 0.62 （0.55 ± 0. 16 ）. Results There was no death, hemorrhage, stroke, arrhythmias, myocardial infarction, postoperative wound infection and other complications in this group. Beating heart coronary artery bypass grafting surgery time was 1.6 to 2.7 （ 1.7 ± 0.9） h. The Endotracheal intubation time was 5 - 13 （7.8 ± 2. 9 ）h. The 24 h pleura] effusion was 65 -410 （213.4 ± 89.3 ）mL. The ICU stay time was 1 - 2 d（ 1.4 ± 0. 5 ） d. The postoperative hospital stay was 5 - 9 （5.7 ± 1.9 ） d. Follow-up duration was 0.7 - 2.7 years, there was no long-term myocardial infarction and death, and no reperation. Condusion ＂One-stop＂ composite technology （Hybrid） in treatment of multivessel coronary artery disease is a safe, effective surgical approach, its long-term efficacy remains to be verified by more clinical applications and clinical trials.

关 键 词：心肌缺血.hybrid技术 外科手术 

分 类 号：R541.4[医药卫生—心血管疾病]