小切口与胸骨正中切口在冠状动脉旁路移植手术中的比较  

Comparison of minimally invasive direct coronary artery bypass grafting and standard coronary artery bypass grafting

作　　者：郭海平[1] 郭建英[1] 赵成秀[1] 郭梅丽 李锐[1] 李延珍[1] 杨健[1] 李忠辉[1] 李良[1] 宋华勇[1] 凌云鹏[1] 

机构地区：[1]邯郸市第一医院心脏外科,056002

出　　处：《心肺血管病杂志》2017年第10期832-834,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:比较左胸小切口冠状动脉旁路移植手术(MIDCAB)与常规正中切口冠状动脉旁路移植手术(CABG)的临床效果。方法:2012年10月至2015年12月,采用左胸小切口取左乳内动脉(LIMA)心脏不停跳CABG术45例和常规正中开胸CABG手术50例。比较术前基本情况、手术时间、出血量、术后疼痛评分、围术期心肌梗死、死亡等指标;所有患者均在术后1年时进行随访,比较术后1年的吻合口再狭窄、心绞痛、心肌梗死、脑卒中及死亡等重要终点事件发生率。结果:入选两组患者术前一般情况无显著差别。两组患者均成功施行不停跳CABG手术,围术期均无死亡。MIDCA组具有手术时间短,围术期出血少等优点。但MIDCAB组术后疼痛程度较常规正中切口CABG组大。两组在围术期心肌梗死发生、切口愈合不良发生率上差异无统计学意义。随访1年时,两组患者在心绞痛、心肌梗死、死亡、脑卒中、吻合口再狭窄等终点事件差异均无统计学意义。结论:MIDCAB术具有与传统正中切口手术一样的近中期效果,MIDCAB术安全可行,值得推广。Objective：We aimed to compare outcomes after minimally invasive direct coronary artery bypass grafting（MIDCAB） versus standard coronary artery bypass grafting. （CABG）. Methods： We compared patients profiles, Operation time, blood loss, post-operative pain scores, pefioperative myocardial infarction, mortality, Poor wound healing and Endpoint Event after one year （Endpoint Event： death, angina,myocardial infarction ,stroke ,restenosis） in 45 patients undergoing MIDCAB and 50 patients undergoing standard coronary artery bypass grafting （CABG） between October 2012 and December 2015. Results： No Statistical difference was seen in patients profiles. There was no death in the whole group. MIDCAB group has the advantages of shorter operative time and less blood loss. But, MIDCAB group was more painful than CABG group. No statistical difference was seen in pefioperative myocardial infarction and Poor wound healing. We did not find statistical difference in endpoint event. Conclution： MIDCAB group and CABG group have same effect in Short and mid term. MIDCAB is safe and feasible, which is worth to be spread.

关 键 词：冠状动脉旁路移植手术 小切口 左乳内动脉 

分 类 号：R54[医药卫生—心血管疾病]