使用双侧乳内动脉行冠状动脉旁路移植术动脉桥即时流量的初步研究  

Preliminary Research of Immediate Graft Flow in Coronary Artery Bypass Grafting Using Bilateral Internal Mammary Artery

作　　者：畅怡[1] 王小啟[1] 郑哲[1] 樊红光[1] 李浩杰[1] 侯剑峰[1] 高歌[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院成人外科中心,北京市100037

出　　处：《中国循环杂志》2017年第11期1080-1084,共5页Chinese Circulation Journal

摘　　要：目的:使用双侧乳内动脉行冠状动脉旁路移植术(CABG)后的右乳内动脉(RIMA)桥血管流量分析,初步探讨动脉桥流量特性。方法:2015-12至2016-07选择在我院年龄<65岁、使用双侧乳内动脉行CABG患者52例,男46例,平均年龄(56.6±6.8)岁,根据前降支(LAD)移植血管材料分为两组,RIMA-LAD吻合组(n=42),左乳内动脉(LIMA)-LAD吻合组(n=10)。使用Veri Q系统行桥血管即时流量测定,比较手术结果及桥流量。结果:52例患者无手术死亡,1例患者出现伤口愈合不良,行清创缝合,余51例无手术并发症。RIMA-LAD组和LIMA-LAD组患者LAD桥平均流量分别为(28.7±11.5)ml/min和(31.8±11.7)ml/min,平均搏动指数为2.3±0.7和2.0±0.4,差异均无统计学意义(P>0.05);两组患者RIMA至不同靶血管平均流量([28.7±11.5)ml/min v(s21.1±11.0)ml/min]、平均搏动指数(2.3±0.7 vs 2.6±1.1),差异均无统计学意义(P>0.05)。结论:RIMA-LAD桥流量与LIMA-LAD桥流量相当,RIMA与其他靶血管吻合,桥流量满意,是稳定理想的冠状动脉旁路血管移植物。Objective：To preliminarily analyze the graft flow of right internal mammary artery（RIMA） in patients after coronary artery bypass grafting（CABG） using bilateral internal mammary artery（BIMA）.Methods：A total of 52 patients received CABG by BIMA in our hospital from 2015-12 to 2016-07 were studied.The patients were younger than 65 years at the mean age of（56.6±6.8） years including 46 male.According to conduit grafting to left anterior descending artery（LAD）,the patients were divided into 2 groups：RIMA anastomosed to LAD group,n=42 and LIMA anastomosed to LAD group,n=10.The immediate graft flow was measured by Veri Q system,surgical outcomes and graft flows were compared between 2 groups.Results：There were no operative death in all 52 patients,1 had poor wound healing and received debridement and suturing,no one had operative complication in left 51 patients.The average LAD bridge flow in both groups were（28.7±11.5） ml/min and（31.8± 11.7） ml/min,the mean pulsation index（PI） were（2.3±0.7） and（2.0±0.4）,P〈0.05;the average RIMA graft flow were（28.7±11.5） ml/min and（21.1±11.0） ml/min,the mean PI were（2.3±0.7） and（2.6±1.1）,P〈0.05.Conclusion：Flows in RIMA-LAD graft and LIMA-LAD graft were similar;the flow of RIMA anastomosed to other target vessel was satisfactory which was an ideal graft for CABG.

关 键 词：冠状动脉旁路移植术 乳内动脉 局部血流 

分 类 号：R541[医药卫生—心血管疾病]