微创冠状动脉搭桥术51例报告  

Off pump coronary artery bypass grafting in 51 cases

作　　者：赵强[1] 王宜青[1] 夏利民[1] 

机构地区：[1]上海医科大学中山医院上海市心血管病研究所,200032

出　　处：《中华外科杂志》2000年第9期652-654,共3页Chinese Journal of Surgery

摘　　要：目的　探讨微创冠状动脉搭桥术的临床实用价值。　方法　自 1998年 8月至 1999年11月 ,5 1例冠心病患者接受微创非体外循环心脏不停跳冠状动脉搭桥术。男性 42例 ,女性 9例 ,年龄 39～ 80 (平均 6 4)岁 ,陈旧性心肌梗死 35例 ,糖尿病 9例 ,左室射血分数 2 0 %～ 72 % ,平均 (5 3±13) %。采用前胸正中切口 ,应用CTS、Octopus、USSC血管固定器 ,搭桥 1～ 4(平均 2 7)根 ,应用左胸廓内动脉 35例、右胸廓内动脉 1例 ,双侧胸廓内动脉 15例 ,桡动脉 3例。　结果　手术死亡 1例 ,病死率 1 9%。平均ICU时间 1 2d ,术后平均 6d出院。平均胸腔引流量和输血分别为 415ml和 16 0ml。随访平均 14个月 ,所有患者心绞痛症状消失 ,活动量增加。 2例患者术后 2个月随访冠脉造影 ,吻合口满意率 10 0 %。　结论　微创冠状动脉搭桥术安全、经济、有效 ,适用于体外循环高危患者 ,并可应用于多支血管病变 。Objective[WT5”BZ] To study the cost effective minimal invasive coronary bypass surgery which decreases the complication associated with cardiopulmonary bypass, alleviates postoperative pain,and promotes recovery. [WT5”HZ]Methods[WT5”BZ] From August 1998 to November 1999, fifty one patients underwent minimal invasive coronary bypass surgery with off pump technique. Age range was from 39 to 80 years (average 64). Thirty five patients suffered from myocardial infarction and nine patients diabetes. Left ventricular ejection fraction was from 20% 72% (average 53%). All procedures were completed through medial sternotomy. Stabilizers of CTS, Octopus, and USSC were applied. The average graft was 2 7 per case. [WT5”HZ]Results[WT5”BZ] The operative mortality was 1 9%.The ave rage ICU and hospital stay were 1 2 and 6 days, respectively. The average chest drainage and blood transfusion were 415 ml and 160 ml, respectively. Fifty patients survived from surgery. All survived patients had no symptoms of angina during the short term follow up (1 to 8 months). Two patients were followed up by postoperative coronary angiography, which showed a satisfactory anastomosis rate of 100%. [WT5”HZ]Conclusions[WT5”BZ] Minimal invasive coronary bypass surgery is safe, cost effective, and suitable for patients with high risk of extracorporeal circulation. It can also be used for multivessel disease.

关 键 词：冠状动脉分流术 微创外科 MIDCAB OPCAB 

分 类 号：R654.2[医药卫生—外科学]