非体外循环下冠状动脉旁路移植术20例报道  

Off-pump coronary artery bypass grafting in 20 cases

作　　者：程兆云[1] 苑星[2] 陈重[1] 顾以茼[1] 高恩民[1] 李俊秀[1] 张立[1] 孟凡民[1] 黄建民[1] 孙明伟[1] 宋芳[1] 陈莎莉[1] 

机构地区：[1]河南省人民医院,郑州市450003 [2]河南省百泉肿瘤医院

出　　处：《河南诊断与治疗杂志》2001年第3期129-130,共2页Henan Journal of Diagnosis and Therapy

摘　　要：目的 :总结非体外循环下冠状动脉旁路移植术 (Off -pumpcoronaryarterybypassgrafting ,OPCAB)的临床经验和效果。方法 :2 0例冠心病人术前均有心绞痛发作史 ,左室射血分数 3 0 %～ 69%。取胸骨正中切口 ,采用Octopus心表稳定器显露固定目标血管拟吻合部位 ,使用血管内分流管 (Shunt)维持冠脉血流和改善术野显露。应用左乳内动脉 2 0例 (其中双侧乳内动脉 3例 )、桡动脉 2例。结果 :无手术死亡 ,无围术期心肌梗死。平均ICU住留时间 1 5d。术后平均 7 5d出院。平均随访 9个月 ,所有患者心绞痛症状消失 ,活动量改善。ECT检查示心肌血供显著改善 ,超声心动图示左室射血分数明显增加。结论 :OPCAB技术安全、经济、有效 ,对于体外循环高危患者尤其有意义。Objective To review retrospectively the experience of off-pump coronary artery bypass grafting(OPCAB).Methods Twenty male patients with coronary artery disease received OPCAB procedure.Twelve patients suffered from old myocardial infarct and 9 were diabetics.The left ventricular ejection fractions were between 30%～69%.A median sternotomy was performed.Octopus stabilizer (Medtronic Inc.USA)was used together with the intra-luminaly shunt to facilitate exposure of the target coronary artery.Left internal mammary artery was usd in all cases,and right internal mammary artery was used in 3 of those patients. Radial artery was harvested in 2 cases. Results There was no operative death.No intra-operative myocardial infarction was observed.The mean ICU stay was 1.5 days and post-operative hospitalization was 7.5 days.A mean follow-up of 9 months was carried out.All patients were free of angina pectoris with an improved exerise tolerance.ECT test demonstrated better myocardial perfusion. Conclusions OPCAB is a safe,economic and effective proceduer for coronary artery disease,with special benefit to patients with high-risk factors in cardiopulmonary bypass. [

关 键 词：冠状动脉 旁路移植术 脱泵 微创外科 OPCAB 

分 类 号：R654.2[医药卫生—外科学]