老年冠心病患者中体外循环与非体外循环下冠状动脉旁路移植术的近期疗效及患者康复情况  

Comparation between Off-pump and On-pum p Coronary Artery Bypass Grafting in Elderly Patients

作　　者：张继倬[1] 韩露[1] 陈兴华[1] 陈杰[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院心脏外科,北京100038

出　　处：《中国医科大学学报》2014年第3期255-258,共4页Journal of China Medical University

基　　金：科技部国际科技交流合作专项(2010DFB33140)

摘　　要：目的对比分析行体外循环冠状动脉旁路移植术(CCAB)和非体外循环冠状动脉旁路移植术(OPCAB)的70岁及以上老年患者手术后的早期临床疗效。方法回顾89例行冠状动脉旁路移植术的70岁及以上老年患者的病历资料,根据术式不同分为体外循环组(CCAB组,39例)和非体外循环组(OPCAB组,50例)。比较2组患者围手术期各项相关指标及术后康复情况。结果 2组比较,手术操作时间、远端吻合口数、术后住院时间无统计学差异(P>0.05),术后呼吸机辅助呼吸时间、ICU治疗时间、术后住院费用的差异有统计学意义(P<0.05),术后3个月左室射血分数和左室舒张末期直径无统计学差异(P>0.05),但OPCAB组总体健康、情感职能、精神健康评分明显高于CCAB组(均P<0.05)。结论 CCAB与OPCAB对于70岁及以上老年冠心病患者均为安全、有效的方法,各有优势,OPCAB对于术后康复更有益。Objective To compare the early outcomes in elderly population （above 70 years old） who undergoing coronary artery bypass grafting with cardiopulmonary bypass or not. Methods A retrospectively study was performed on 89 patients admitted during 2006 - 2012, including 39 with conventional coronary artery bypass （CCAB） and 50 with off-pump coronary artery bypass （OPCAB）. The outcomes for two groups were com- pared. Quality of life was assessed using the short-form 36 health survey questionnaire （SF-36）. Results Them were marked differences in ventilat- ing hours, ICU residence time and operative expenses between the two groups. 3 months after operation, there was no significant difference in postop- erative LVEF, LVDD. The SF-36 scores of general health, role emotional and mental health in group OPCAB were higher than those in group CCAB （P 〈 0.05 ）. Conclusion In elderly patients, CCAB and OPCAB are safe and effective methods through the data of early postoperative period （3 months）. Quality of life at 3 months is superior in OPCAB than CCAB.

关 键 词：冠状动脉旁路移植术 体外循环 非体外循环 

分 类 号：R654.2[医药卫生—外科学]