升主动脉不接触技术在非体外循环冠状动脉旁路移植术中的应用  

作　　者：张峰[1] 戴炳光[1] 曲崎[1] 

机构地区：[1]山东省济南市第四人民医院心外科,250031

出　　处：《当代医学》2013年第3期84-85,共2页Contemporary Medicine

摘　　要：目的对升主动脉不接触技术在非体外循环冠状动脉旁路移植术(OPCABG)中的应用进行总结。方法回顾性分析28例合并升主动脉粥样硬化的冠心病患者临床资料。4例采用双侧乳内动脉原位移植,LIMA与LAD吻合,RIMA与右冠主干或其分支吻合。24例采用单侧LIMA,首先行LIMA与LAD吻合,余大隐静脉近心端或桡动脉远端分别与对角支、回旋支和右冠状动脉等血管吻合,远端吻合到LIMA上,形成Y型或T型桥,所有患者主动脉根部无吻合口。结果全组无死亡,手术均顺利完成,痊愈出院,术后心房颤动3例,肺部感染3例,切口感染2例,随访3个月～2年,无脑部及其他神经系统并发症。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技术,可有效减少术后神经系统并发症的发生,临床效果满意。Objective To summarize the application of aorta not contact （no-touch） technology in the extracorporeal circulation coronary artery bypass grafting （OPCABG）. Methods Clinical material of 28 patients with aortic atheroma liters with coronary heart disease were retrospectively analyzed. Four patients with bilateral breast artery in situ transplantation, LIMA in agreement with the LAD, RIMA and right crown backbone or its branch identical. 24 patients with unilateral LIMA, first line LIMA and Saphenous vein anastomosis, LAD near the distal radial heart or respectively with a diagonal, swing of teams, and right coronary artery blood vessels, such as identical to the far end anastomosis LIMA, form Y or T bridge, all patients with aortic root no anastomosis. Results The group had no death, they were performed successfully completed, well after hospital discharge, atrial fibrillation in 3 cases, 3 cases of lung infection, the incision infection in 2 cases, without the brain and other nerve system complications. Conclusion The combination of coronary heart disease up aortic atheroma the OPCABG/aorta with no contact technology, which can effectively reduce postoperative neurological complications, has satisfactory effect.

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：R654.2[医药卫生—外科学]