一站式杂交手术在冠心病多支病变中的应用体会(附20例病例报告)  

Application Experience of One-Stop Hybrid Coronary Revascularization for Patients with Multivessel Coronary Artery Disease

作　　者：尚玉强[1] 戴仕林[1] 李炳[1] 易凡[1] 吴伟[1] 程龙[1] 王贤灿[1] 夏家红[1] 

机构地区：[1]武汉市中心医院,湖北武汉430014

出　　处：《武汉大学学报（医学版）》2015年第6期964-966,985,共4页Medical Journal of Wuhan University

摘　　要：目的:评价心脏一站式杂交手术在治疗冠心病多支病变中的临床应用。方法:2013年12月-2014年9月共有20例冠心病患者进行了心脏一站式杂交手术,所有的患者均为包括前降支病变在内的多支血管病变的患者。所有的患者均由外科医生先通过小切口完成左乳内动脉与前降支血管的吻合后,再由心内科医生经皮冠状动脉介入手术治疗其他的病变血管。结果:本组患者均顺利完成一站式杂交手术,住院期间死亡1例,再次开胸止血1例,术后发生胸腔积液4例,心房纤颤2例,住院期间未出现脑血管事件。结论:心脏一站式杂交技术是治疗冠心病多支病变患者的一种有效的方法,但在临床早期应用中,术中出血及术后早期引流量偏多仍然是其所面临的主要问题。Objective：To evaluate the clinical application of one-stop hybrid coronary revascularization for patients with multivessel coronary artery disease.Methods：From December 2013 to September 2014,20 consecutive patients underwent one-stop hybrid coronary revascularization.All the patients had multivessel coronary artery disease including left anterior descending（LAD）coronary artery stenosis.The distal anastomosis in situ left internal mammary artery（LIMA）to LAD graft was completed through minimally invasive coronary artery bypass grafting.And percutaneous coronary intervention（PCI）was performed on the non-LAD lesions by cardiovascular physicians.Results：Among all the patients undergoing one-stop hybrid coronary revascularization,one case died during in hospital,and one case underwent reoperation for hemostasis.Pleural effusion occurred after operation in 4cases,and atrial fibrillation occurred in 2cases.No neurologic event occurred during in hospital.Conclusion：One-stop hybrid coronary revascularization is a feasible therapy for patients with multivessel cornary artery disease.In the early clinical application,hemostasis is the main problem faced.

关 键 词：微创冠状动脉搭桥 经皮冠状动脉介入 一站式杂交 

分 类 号：R654.1[医药卫生—外科学]