内窥镜采集大隐静脉在高龄患者冠状动脉旁路移植术中的应用效果  

Efficacy of great saphenous vein harvested by endoscope applied to coronary artery bypass grafting in patients with advanced ages

作　　者：李晓密[1] 韩宏光[1] 王辉山[1] 吴海波[1] 姜辉[1] 陶登顺[1] 

机构地区：[1]沈阳军区总医院心外科,沈阳市110016

出　　处：《广西医学》2016年第9期1249-1251,1266,共4页Guangxi Medical Journal

摘　　要：目的评价内窥镜采集大隐静脉在高龄冠心病患者冠状动脉旁路移植术(CABG)中的应用效果。方法选取拟行CABG的冠心病患者336例,按年龄分为高龄组(年龄≥75岁)98例,低龄组(年龄<75岁)238例,两组患者术中均采用内窥镜取大隐静脉,比较两组取材及手术时间、取材质量、下肢手术并发症等情况。结果两组的静脉血管桥长度、大隐静脉修补次数、切口长度及切口缝合时间比较,差异无统计学意义(P>0.05),而高龄组获取大隐静脉时间及手术总时间短于低龄组(P<0.05),术后下肢麻木、皮下血肿、水肿、切口中度以上疼痛发生率也低于低龄组(P<0.05)。结论内窥镜采集大隐静脉作为一种微创取血管的方法,取材质量良好、切口小、并发症少,用于CABG安全有效,尤其适用于75岁以上高龄冠心病患者。Objective To evaluate the efficacy of great saphenous vein harvested by endoscope applied to coronary artery bypass grafting（CABG） in coronary heart disease patients with advanced ages. Methods A total of 336 patients with coronary heart disease who planned to undergo CABG were enrolled, and were divided into advanced age group（ age ≥75 years, n = 98 ） and younger group（ age 〈 75 years ,n = 238 ） based on their ages. Great saphenous veins of patients in both groups were harvested by endoscope during surgery. The harvesting and surgical duration, quality of vessels, surgical complications of low extremities were compared between two groups. Results There were no significant differences in the length of vein graft, times for great saphenous vein repair, incision length or duration for incision suture between two groups（ P 〉 0.05 ） , but the achievement time for great saphenous vein and total surgical duration in the advanced age group were less than those in the younger group （ P 〈 0.05 ）. After surgery, the incidence rates of numbness, subcutaneous hematoma, edema, moderate and severe incision pain of lower extremities in the advanced age group were lower than those in the younger group （P 〈 0.05）. Conclusion Endoscopic harvesting for great saphenous vein is a minimally invasive approach, and obtains a good quality of harvested vessels, small incision and less complications. And it is safe and effective for CABG, especially in the patients older than 75 years.

关 键 词：冠心病 冠状动脉旁路移植术 内窥镜 大隐静脉 高龄 

分 类 号：R654.4[医药卫生—外科学]