一站式杂交手术治疗冠状动脉三支血管病变近期疗效观察  

Short-term curative effect of one-stop hybrid treatment for triple-vessel lesions of the coronary artery

作　　者：钱松屹[1] 刘鹏[1] 叶志东[1] 王非[1] 林凡[1] 杨煜光[1] 樊雪强[1] 甄雅楠[1] 郑夏[1] 王凤林[1] QIAN Song-yi;LIU Peng;YE Zhi-dong;WANG Fei;LIN Fan;YANG Yu-guang;FAN Xue-qiang;ZHEN Ya-nan;ZHENG Xia;WANG Feng-lin(Department of Cardiac&Vascular Surgery,Chinese-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院心脏.血管外科,北京100029

出　　处：《中国临床医学》2018年第2期226-229,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨一站式杂交手术治疗冠状动脉三支血管病变的安全性及有效性。方法:2011年1月至2014年6月,34例冠状动脉三支血管病变患者接受非体外循环冠脉旁路移植术(off-pump coronary artery bypass graft,OPCAB)联合经皮冠脉介入治疗术(percutaneous coronary intervention,PCI),观察患者近期疗效及并发症发生情况。结果:34例患者均成功完成手术,无术中死亡,OPCAB共完成41处远心端吻合,同期PCI植入冠脉支架46枚。术后即刻DSA造影示移植物及支架内无闭塞发生。患者术后恢复可,无心绞痛发作,无围术期死亡,无心脑血管事件发生,无二次开胸探查。术后平均随访(36±8)个月,患者无再发心绞痛,未再接受医疗干预。结论:一站式杂交手术治疗冠状动脉三支血管病变安全、有效,近期预后良好。Objective:To evaluate the safety and effectiveness of one-stop hybrid therapy for triple-vessel coronary disease.Methods:Totally 34 patients with triple vessel coronary disease were treated by off-pump coronary artery bypass graft(OPCAB)combined with percutaneous coronary intervention(PCI)from Jan.2011 to Jun.2014.All 34 patients received PCI firstly,46 stents implanted in coronary arteries,and then OPCAB were performed,41 distal anastomosis were completed.Results:The one-stop hybrid procedure was successful in all patients.Selective coronary angiography immediately after one-stop hybrid procedure showed that grafts and stents were unobstructed.There was no death during the operation and perioperative period,no episodes of angina attack,no cardio-cerebrovascular events,no bleeding postoperatively and second exploratory thoracotomy.All patients remained free from angina,cardiac function improved significantly and no patient need medical intervention during the(36±8)months follow-up period.Conclusions:One-stop hybrid cardiac surgery provides a reasonable,feasible,and safe alternative for treating patients with coronary artery triple-vessel lesions,and it has good prognosis.

关 键 词：冠状动脉粥样硬化性心脏病 经皮冠脉介入治疗 非体外循环冠状动脉旁路移植术 杂交手术 

分 类 号：R654.3[医药卫生—外科学]