CCABG和OPCAB两种术式冠脉搭桥术后神经系统并发症的分析  

Analysis of neurological complications after on-pump and off-pump CABG

作　　者：付勇 于风旭 邓明彬 李新 廖斌 

机构地区：[1]四川医科大学附属第一医院胸心外科,四川泸州646000

出　　处：《泸州医学院学报》2015年第6期554-557,共4页Journal of Luzhou Medical College

基　　金：四川省教育厅课题(15ZA0170);四川省科技厅-泸州市科技局-泸州医学院联合项目(LZ-LY-53)

摘　　要：目的:分析CCABG和OPCAB两种术式冠脉搭桥术后患者神经系统并发症的发生,探讨体外循环下和非体外循环下CABG术后发生神经系统并发症的特点。方法:冠脉搭桥手术患者64例,根据手术是否采用体外循环,分为A组(体外循环下CABG术,n=34)和B组(非体外循环下CABG术,n=30),术前均行冠脉造影、心脏彩超、颈动脉彩超检测,神经认知功能评价,术后行心脏彩超及神经认知功能评价;对两组患者临床资料进行统计分析。结果:两组患者一般资料差异无统计学意义;A组患者手术时间、术后ICU住院时间、术后住院时间较B组长(439.71±74.29 VS 280.17±57.60,39.65±12.02 VS 22.39±8.51,13.32±2.41 VS 11.50±2.21,P<0.05),以及II类神经系统并发症发生率较B组高(67.65%VS 26.67%,P<0.05);两组I类神经系统并发症发生率差异无统计学意义。结论:体外循环下CABG术较非体外循环下CABG术II类神经系统并发症发生率高。Objective： To characterize the neurological complications after coronary artery bypass graft（CABG）, and to compare the outcomes between on-pump and off-pump CABGs. Methods： 64 CABG surgery patients, based on having cardiopulmonary bypass（CPB） or not, were divided into on-pump CABG surgery group A（n = 34） and off-pump CABG surgery group B（n = 30）. Patients in two groups were all undergone coronary angiography, echocardiography, carotid ultrasonography, and assessement of neurocognitive impairment before surgery, and were evaluated after surgery by echocardiography and neurocognitive impairment assesement. The data were analysed statistically. Results： The two groups are comparable in terms of general clinical characteristics. Compared to group B, patients in group A tend to have longer operation time, postoperative ICU stay, and postoperation hospital stay, and higher incidence of Class II Neurological complications（P〈0.05）. No statistically significant difference in the incidence of neurological complications of Class I was observed between the two groups. Conclusion： The incidence of Class II neurological complications in on-pump CABG surgery was higher than that of off-pump CABG surgery.

关 键 词：冠心病 体外循环 冠状动脉旁路移植术 神经系统并发症 

分 类 号：R654.2[医药卫生—外科学] R541.4[医药卫生—临床医学]