翻转胸廓内动脉在冠状动脉搭桥术中应用的可行性研究  

FEASIBILITY STUDY OF FLIPPING THE INTERNAL THORACIC ARTERY IN CORONARY ARTERY BYPASS GRAFTING

作　　者：陈伟彬 冯莉 徐永平 李伟兰 张惠英 Chen Weibin;Feng Li;Xu Yongping(A ffiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院

出　　处：《中国煤炭工业医学杂志》2019年第6期561-565,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省科技计划项目(编号:162777140)

摘　　要：目的应用多层螺旋CT血管造影术观察翻转胸廓内动脉在冠状动脉搭桥术中的应用价值。方法观察分析2015年3月-2018年5月200例于我院同时行胸主动脉和冠状动脉CTA检查患者的病例影像学图像,并分别测量左、右两侧第6肋间隙以上胸廓内动脉各肋间中点内径,各肋间中点到胸廓内动脉起点、以及到冠状动脉前降支中点的距离,测量冠状动脉前降支、左旋支及右冠状动脉中点内径,并对所得数据进行统计学分析。结果左、右两侧胸廓内动脉第5肋间隙以上各肋间中点内径与冠状动脉前降支、左旋支及右冠状动脉中点内径比较差异无统计学意义(P>0.05),左侧胸廓内动脉第3肋间以上各肋间中点到起点的距离短于到冠状动脉前降支中点的长度(P<0.05);右侧第4肋间以上各肋间中点到起点的距离短于到冠状动脉前降支中点的长度(P<0.05)。结论胸廓内动脉内径与冠状动脉三大分支内径相近,且于近端切断游离胸廓内动脉可以满足翻转胸廓内动脉冠状动脉搭桥术,保证逆向供血。Objective To observe the value of flipping the internal thoracic artery in coronary artery bypass grafting by multislice spiral CTA.Methods From March 2015 to May 2018,the imaging images of two hundred patients who underwent thoracic aorta and coronary artery CTA examination at the same time in Affiliated Hospital of North China University of Science and Technology were observed and analyzed.The inner diameter of the intercostal midpoints of the internal thoracic artery above the 6 th intercostal space on the left and right sides,the distance between the midpoints of the intercostal midpoints and the starting point of the internal thoracic artery and the midpoint of the anterior descending coronary artery were measured respectively,the inner diameter of the anterior descending branch,the left circumflex branch and the middle point of the right coronary artery were measured and statistically analyzed.Results There were no statistically significant difference among the inner diameter of the middle intercostal points above the 5 th intercostal space of the internal thoracic artery on both sides and the inner diameter of the middle intercostal points of the anterior descending coronary artery,the left circumflex branch and the right coronary artery(P>0.05).The distance from the midpoint above the 3 rd intercostal space of the left internal thoracic artery to the starting point were shorter than that to the midpoint of the anterior descending coronary artery(P<0.05).The distance from the midpoint above the 4 th intercostal space of the right internal thoracic artery to the starting point were shorter than that to the midpoint of the anterior descending coronary artery(P<0.05).Conclusion The diameter of the internal thoracic artery is similar to that of the three branches of coronary artery,and the proximal dissection of the free internal thoracic artery can meet the requirements of reversing the coronary artery bypass surgery to ensure the reverse blood supply.

关 键 词：胸部动脉 冠状动脉搭桥术 体层摄影术 血管造影术 

分 类 号：R816.2[医药卫生—放射医学]