微创体外循环对冠状动脉旁路移植术的临床效果观察  

Clinical effect observation of minimal extracorporeal circulation in coronary artery bypass grafting

作　　者：熊德生[1] 

机构地区：[1]武汉亚洲心脏病医院体外循环科,430022

出　　处：《临床外科杂志》2013年第8期631-633,共3页Journal of Clinical Surgery

摘　　要：目的 观察微创体外循环（MECC）对冠状动脉旁路移植术临床效果的影响.方法 将60例在我院行进行冠状动脉旁路移植术的患者分为MECC组、传统的心肺旁路（CCPB）组各30例.记录患者术中、术后各项临床指标并进行分析.结果 两组患者年龄、性别、体表面积、术前血红蛋白、术前血球压积以及左室射血分数比较,差异无统计学意义.术中两组病例阻断时间和总转流时间均无差异,但转中最低血红蛋白和体外用血量存在明显差异（P ＜0.001）.ICU红细胞用量MECC组少于CCPB组（P＜0.05）;ICU机械通气时间MECC组明显少于CCPB组；ICU住院时间两组无差异.ICU第一个24小时胸引量MECC组少于CCPB组（P＜0.05）.结论 MECC与CCPB相比,在冠状动脉旁路移植术中是安全可靠的,能大幅减少血液制品的使用.Objective To observe the clinical effects of minimal extracorporeal circulation （MECC） on coronary artery bypass grafting.Methods The 60 cases accepted coronary artery bypass grafting from Mar.2011 to Dec.2011 were randomly divided into the MECC group（n =30） and the conventional cardiopulmonary bypass（CCPB） group（n =30）.The clinical data of perioperative and postoperative period were analyzed for each patient.Results There were no differences between the two groups in age,gender,body surface area,preoperative hemoglobin,preoperative hematocrit and left ventricular ejection fraction.During the operation,there were no differences between the two groups of cases in clamping time and total bypass time.But there were significant differences in the lowest hemoglobin and the amount of transfusion（P ＜ 0.001）.The RBC amount of intensive care unit（ICU） in MECC group was less than that of the CCPB group（P ＜0.05） ; the postoperative ventilation time was significantly less in the MECC group compared to the CCPB group; there was no difference was in ICU stay.The chest tube drainage was less in the MECC group compared to the CCPB group （P ＜ 0.05）.Conclusion Compared with CCPB,MECC system is safe and reliable on coronary artery bypass graft （CABG） surgery,which can greatly reduce the use of blood products.

关 键 词：冠状动脉旁路移植术 微创 体外循环 

分 类 号：R654.1[医药卫生—外科学]