体外循环与非体外循环下冠状动脉旁路移植术早期疗效的比较  

Comparisons of Early Outcome between On-pump and Off-pump Coronary Artery Bypass Grafting

作　　者：顾军[1] 吴云江[1] 范黄新[1] 王哲[2] 包阳[1] 

机构地区：[1]江苏省扬州市第一人民医院心胸外科,江苏扬州225001 [2]上海瑞金医院胸心外科,上海200025

出　　处：《实用临床医药杂志》2014年第23期48-50,共3页Journal of Clinical Medicine in Practice

摘　　要：目的比较体外循环和非体外循环下2种冠状动脉旁路移植手术的早期疗效。方法回顾性分析2002年4月—2014年4月353例冠状动脉旁路移植术患者临床资料,其中体外循环下冠状动脉旁路移植术(CABG)组168例,非体外循环下冠状动脉旁路移植术(OPCAB)组185例,比较2组术后早期死亡率及合并症发生情况。结果 2组患者术前资料基本相似。OPCAB组在手术时间、输血量、术后24 h引流量、术后血管活性药物支持时间、ICU停留时间、住院费用、住院天数方面均明显少于CABG组(P<0.05)。2组术后早期死亡率、住院时间及术后机械通气时间,以及术后心肌梗死、低心排出量、脑梗死、肾功能不全、新发房颤等并发症发生率差异无统计学意义(P>0.05)。结论 OPCAB早期疗效优于CABG,不增加术后心肌梗死、低心排、脑梗死、肾功能不全发生率及围术期死亡率。Objective To systemically compare the early outcome between on-pump and off -pump coronary artery bypass grafting （CABG）.Methods Retrospective database and medical record review from April 2002 to April 2014,185 consecutive patients enrolled in the off-pump CABG （OPCAB） were compared with 168 consecutive on-pump patients from the Yangzhou No.1 People＇s Hospital.The early post-operative mortality and complications of two groups were compared.Results Preoperative characteristics were similar in both groups.Patients undergoing OPCAB had significantly fewer complications overall,including decreased operative time,volume of blood transfusion,postoperative 24-hour drainage volume,vasoactive agent support time,intensive care unit stay,cost and time of hospitalization （P 〈 0.05）.No significant differences in early postoperative mortality,ventilator time,myocardial infarction,stroke,renal insufficiency,low cardiac output or new-onset atrial fibrillation were observed between the two groups （P 〉0.05）.Conclusion Compared with CABG,OPCAB receives superior short term outcome in the treatment of coronary artery disease.

关 键 词：早期疗效 体外循环 非体外循环 冠状动脉旁路移植术 

分 类 号：R541[医药卫生—心血管疾病]