腔镜辅助下取大隐静脉方法在冠状动脉旁路移植术中的应用  

Application of endoscopic saphenous vein harvesting in coronary bypass grafting

作　　者：申运华[1] 严中亚[1] 卢中[1] 郑理[1] 王芳[1] 朱正艳[1] 雷虹[1] 

机构地区：[1]安徽医科大学附属省立医院心脏外科,合肥230001

出　　处：《临床心血管病杂志》2015年第2期156-158,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨腔镜辅助下切取大隐静脉在冠状动脉旁路移植术(CABG)患者中应用的可行性、安全性及疗效,并与传统方法取大隐静脉进行比较。方法:我科48例应用大隐静脉CABG的患者中,采用传统方法切取大隐静脉26例(Ⅰ组),腔镜辅助下取大隐静脉22例(Ⅱ组)。比较两组患者一般情况及取大隐静脉时间、所取大隐静脉长度、术后下肢切口疼痛需应用镇痛药、下肢局部麻木、下肢切口愈合不良及下肢切口周围瘀斑等方面的差异。结果:两组患者一般情况无明显差异;两种方法对大隐静脉均无损伤,取材大隐静脉长度无明显区别,Ⅰ组取大隐静脉时间小于Ⅱ组(P<0.05),Ⅱ组术后下肢切口疼痛需应用镇痛药例数、下肢局部麻木例数、下肢切口愈合不良及下肢切口周围瘀斑均小于Ⅰ组(均P<0.05)。结论:腔镜辅助下取大隐静脉是安全可行的,其手术时间相对较长,但其切口美观,创伤小,且能明显减少传统方法的腿部并发症。Objective：To compare the clinical effects of endoscopic saphenous vein harvesting and conventional saphenous vein harvesting in coronary artery bypass grafting. Method：Forty-eight cases of patients who were un- derwent coronary artery bypass grafting in our hospital were selected and divided into conventional vein harvesting group （Group Ⅰ , n=26） and endoscope vein harvesting group （Group Ⅱ , n=22）. We observed the operation and the incidence of postoperative leg-wound. Result： Two methods had no significant difference in injury and length of saphenous vein. It spent less time in Group Ⅰ than that in Group Ⅱ （P〈0.05）. The number of pa- tients in Group Ⅱ with lower limb numbness, poor incision healing, incision ecchymosis and analgesics needing were lower than those in Group Ⅰ （all P〈0. 05）. Conclusion： Endoscopic saphenous vein harvesting in coronary ar- tery bypass grafting is safe and feasible. It significantly reduces postoperative leg pain and wound complications compare with conventional saphenous vein harvesting in coronary artery bypass grafting.

关 键 词：冠状动脉旁路移植 腔镜 大隐静脉 

分 类 号：R541.4[医药卫生—心血管疾病]