冠状动脉旁路移植术中靶血管狭窄程度对桡动脉桥通畅率的临床研究  

Correlation between radial artery graft patency and the degree of native coronary stenosis in coronary artery bypass grafting

作　　者：李金东[1] 武艳红[1] 董铭峰[1] 王建堂[1] 柴守栋[1] 唐培哲[1] 

机构地区：[1]山东省聊城市人民医院心外科,252000

出　　处：《中国医师进修杂志》2017年第7期638-641,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 研究在冠状动脉旁路移植术中靶血管狭窄程度的不同，对桡动脉血管桥远期通畅率的影响。方法 回顾性分析290例非体外循环下行冠状动脉旁路移植术患者的临床资料，均采用左乳内动脉、桡动脉和大隐静脉作为桥血管。根据术前右冠状动脉狭窄程度将患者分为三组：右冠状动脉狭窄50%~75% 85例（Ⅰ组），右冠状动脉狭窄76%~89% 95例（Ⅱ组），右冠状动脉狭窄90%~100% 110例（Ⅲ组）。术后随访2~5年，应用CT冠状动脉造影评估各血管桥的通畅率。结果 三组患者无死亡，未发生严重并发症。三组患者左乳内动脉血管桥总通畅率为93.3%（270/290），大隐静脉血管桥总通畅率为70.2%（433/617），桡动脉血管桥总通畅率为69.7%（202/290）。Ⅱ组和Ⅰ组桡动脉通畅率比较差异无统计学意义（P〉0.05）；Ⅲ组桡动脉桥通畅率明显高于Ⅱ组和Ⅰ组[85.5%（94/110）比68.4%（65/95）和50.6%（43/85）]，差异有统计学意义（P〈0.05）。Ⅲ组桡动脉血管桥通畅率明显高于大隐静脉血管桥通畅率[85.5%（94/110）比71.5%（168/235）]，差异有统计学意义（P〈0.05）。三组左乳内动脉血管桥通畅率和大隐静脉血管桥通畅率比较差异无统计学意义（P〉0.05）。结论 冠状动脉旁路移植术中，靶血管狭窄程度对桡动脉血管桥中、远期通畅率有很大影响，右冠状动脉术前狭窄≥ 90%的患者，术后桡动脉血管桥有较高的通畅率。Objective To study the correlation between radial artery graft patency and the degree of native coronary stenosis in coronary artery bypass grafting.Methods The clinical data of 290 patients who had underwent off-pump coronary artery bypass grafting were retrospectively analyzed. The left internal mammary artery, radial artery and saphenous veins were as grafts. The patients were divided into 3 groups according to the stenosis of right coronary artery before operation： group Ⅰ （right coronary artery stenosis 50%-75%, 85 cases）, group Ⅱ （right coronary artery stenosis 76%-89%, 95 cases） and group Ⅲ （right coronary artery stenosis 90%-100%, 110 cases）. The patients were followed up for 2 to 5 years, and the graft patency was assessed using CT coronary angiography.Results There was no death and serious complications in 3 groups. Among the 3 groups, the total graft patency rate of left internal mammary artery grafts was 93.3% （270/290）, the total graft patency rate of saphenous veins grafts was 70.2% （433/617）, and the total graft patency rate of radial artery grafts was 69.7% （202/290）. There was no statistical difference in the graft patency rate of radial artery grafts between group Ⅱ and group Ⅰ （P〉0.05）. The graft patency rate of radial artery grafts in group Ⅲ was significantly higher than that in group Ⅱ and group Ⅰ： 85.5% （94/110） vs. 68.4% （65/95） and 50.6% （43/85）, and there was statistical difference （P〈0.05）. The graft patency rate of radial artery grafts was significantly higher than the graft patency rate of saphenous veins grafts in group Ⅲ： 85.5% （94/110） vs. 71.5% （168/235）, and there was statistical difference （P〈0.05）. There were no statistical differences in the graft patency rates of left internal mammary artery grafts and saphenous veins grafts among 3 group （P〉0.05）.Conclusions The correlation between radial artery graft patency and the degree of native coronary stenosis is significant in coronary artery

关 键 词：冠状动脉旁路移植术 非体外循环 桡动脉 回顾性研究 

分 类 号：R654.2[医药卫生—外科学]