非体外循环下冠状动脉旁路移植术的远期桥血管通畅率调查  

Long-term outcomes of off-pump coronary artery bypass grafting

作　　者：刘国鹏[1] 尚亮[1] 肖苍松[1] 吴扬[1] 王嵘[1] 龚志云[1] 闫军兰[1] 高长青[1] Liu Guopeng Shang Liang Xiao Cangsong Wu Yang Wang Rong Gong Zhiyun Yan Junlan Gao Changqing(Department of Cardiovascular Surgery, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院心血管外科,北京100853

出　　处：《中华医学杂志》2017年第22期1710-1713,共4页National Medical Journal of China

摘　　要：目的分析行非体外循环下冠状动脉旁路移植术（OPCABG）患者的桥血管远期通畅率。方法2000年1月至2015年12月，解放军总医院1129例冠状动脉粥样硬化性心脏病患者由同一术者主刀完成OPCABG，其中男937例，女192例，年龄29～83（62．0±9．6）岁，随访出院后桥血管通畅率及重复再血管化率。结果随访成功率93．8％（1059／1129），随访时间为29～192（95．6±34．1）个月。术后5年总体乳内动脉桥通畅率为96．1％，总体静脉桥通畅率为92．8％；术后10年总体乳内动脉桥通畅率为95．4％，总体静脉桥通畅率为81．4％；术后15年总体乳内动脉桥通畅率为93．7％，总体静脉桥通畅率为70．9％；术后16年总体乳内动脉桥通畅率为93．2％，总体静脉桥通畅率为68．3％。共有69例（6．11％）患者进行了支架植入等再血管化治疗。结论冠心病患者行OPCABG是一种有效的手术方法，远期桥血管通畅率满意。Objective To investigate the long-term outcomes of off-pump coronary artery bypass grafting （OPCABG）. Methods Clinical data of 1 129 consecutive patients （ 937 males and 192 females） with coronary artery disease receiving OPCABG at Department of Cardiovascular Surgery, Chinese PLA General Hospital between January 2000 and December 2015 was retrospectively analyzed. The age of patients ranged from 29 to 83 years, with a mean age of （62. 0 ± 9.6） years. The follow-up data of the patients, including the grMt patency and repeated revascularization rate, were analyzed. Results Of the 1 129 patients analyzed, 1 059 cases （93.8%） were available for follow-up for 29 - 192 months[ with a mean time of （95.6 ±34. 1 ） months]. The 5-year,10-year, 15-year and 16-year graft patency rate of arterial graft was 96. 1%, 95.4%, 93.7% and 93.2%, respectively. The 5-year, 10-year, 15-year and 16-year graft pateney rate of venous graft was 92. 8% , 81.4% , 70. 9% and 68.3% , respectively. During the follow-up, 69 （6. 11% ） patients underwent repeated revaseularization procedures. Conclusion OPCABG is safe and effective with a good long-term graft patency rate.

关 键 词：冠状动脉旁路移植术 非体外循环 治疗结果 随访研究 远期通畅率 

分 类 号：R654.2[医药卫生—外科学]