冠状动脉旁路移植与冠脉支架植入杂交手术的早期临床效果观察  

The clinical effect of coronary artery bypass grafts and coronary stenting hybrid operation

作　　者：严宇[1] 杨庆军[1] 陈灏 吴洪坤[1] 罗永金[1] 余杨[1] 喻鹏凌[1] 

机构地区：[1]重庆市中山医院心脏外科,400013

出　　处：《重庆医学》2014年第13期1568-1569,1572,共3页Chongqing medicine

摘　　要：目的探讨冠状动脉旁路移植与冠脉支架植入杂交手术的早期临床效果。方法回顾性分析该院12例行冠状动脉旁路移植与冠脉支架植入杂交手术患者,观察12例杂交手术患者的术中和术后的一般情况、杂交手术前和术后肝肾功能、杂交手术前后血脂水平、杂交手术前后的肌酸激酶同功酶(CK-MB)和肌钙蛋白(cTnI)水平的比较。结果手术均获得成功,无死亡、大出血等术中意外发生,杂交手术对患者的肝肾功能无明显的影响(P>0.05),术后1个月患者血液中保护性高密度脂蛋白胆固醇(HDL-C)水平相对于术前明显升高(P<0.01),而对冠心病具有促进作用的低密度脂蛋白胆固醇(LDL-C)、血清总胆固醇(TC)和三酰甘油(TG)水平明显下降(P<0.05),手术创伤虽然会引起CK-MB和cTnI暂时性增高,但术后1个月患者的CK-MB和cTnI恢复至正常水平(P<0.05)。结论冠状动脉旁路移植与冠脉支架植入杂交手术创伤小、术后恢复快,无明显的并发症,但因本研究入组患者较少,随访时间较短,其具体疗效还需进一步地深入研究。Objective To investigate the clinical effect of coronary artery bypass grafts and coronary stenting hybrid operation. Methods We retrospective analysised of 1 2 cases of hybrid surgery,observed 1 2 patients with hybrid operation of intraoperative and postoperative general situation,the liver and kidney function before surgery and postoperative,blood lipid levels before and after operation,CK-MB and cTnI levels before and after operation were observed.Results Operation was successful and there was no in-traoperative accident death or bleeding.hybrid surgery of liver and kidney function in patients were similar（P〉0.05）,The blood level of protective HDL-C were significantly decreased after surgery（P〈0.01）,while LDL-C,TC and TG levels significantly de-creased（P〈0.05）,although surgical trauma can cause increased CK-MB and cTnI temporarily,but CK-MB and cTnI return to nor-mal levels after 1 month（P〈0.05）.Conclusion Coronary artery bypass graft hybridization and coronary stenting surgery with lit-tle inj ury and pain,rapid recovery,and no obvious complications,as only 1 2 patients this research and the follow-up time is shorter, further study are needed to clarify the effect of hybrid operation.

关 键 词：冠状动脉旁路移植 冠脉支架植入 杂交手术 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]