OPCABG在高危冠心病应用中的疗效及可行性分析  

Therapeutic effect and feasibility analysis of OPCABG in high-risk COrOnary heart disease

作　　者：黄创业[1] 吴辉龙 何勇[1] 刘光强[1] 李中杰[1] HUANG Chuangye;WU Huilong;HE Yong;LIU Guangqiang;LI Zhongjie(Gaozhou People's Hospital,Maoming,Guangdong,525200,China)

机构地区：[1]高州市人民医院心血管外二科,广东茂名525200

出　　处：《中国急救复苏与灾害医学杂志》2020年第2期148-151,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：广东省医学科学技术研究基金项目(编号:A2018475)。

摘　　要：目的探讨非体外循环冠状动脉旁路移植术(OPCABG)在高危冠心病应用中的疗效及可行性。方法以高州市人民医院2016年1月-2018年1月收治的108例高危冠心病(CHD)患者为研究对象,根据患者住院单双号分为观察组(54例)和对照组(54例),观察组给予OPCABG,对照组给予体外循环冠状动脉旁路移植术(CABG);对比两组手术相关指标、并发症及预后。结果观察组手术时间(3.56±0.83)h、桥血管个数(2.97±0.24)个、动脉桥使用率100%、静脉桥血管远端吻合口数(3.36±0.47)个、二次开胸率1.85%、气管切开率5.56%、左室射血分数(LVEF)(53.64±7.89)%,N末端B型脑钠肽前体(NT-proBNP)(425.43±68.21)μg/L,与对照组[手术时间(3.82±0.91)h,桥血管个数(2.95±0.26)个,动脉桥使用率100%,静脉桥血管远端吻合口数(3.54±0.56)个,二次开胸率9.26%,气管切开率9.26%,LVEF(52.76±8.14)%,NT-proBNP(432.16±74.45)μg/L]比较无明显差异(P>0.05);观察组输血量(693.24±87.36)mL、住院天数(2.23±0.54)d及ICU住院天数(14.67±4.85)d明显低于对照组[输血量(952.18±106.74)mL,住院天数(3.56±0.72)d,ICU住院天数(18.86±6.52)d](P<0.05)。观察组脑肝肾损伤并发症发生率(0.00%)明显低于对照组(7.41%)(P<0.05);随访16个月,观察组预后与对照组无明显差异(P>0.05)。结论OPCABG在高危冠心病应用中手术效果较好,能够明显减少患者输血量、住院时间及ICU住院天数,降低患者并发症发生率。Objective To investigate the efficacy and feasibility of OPCABG in the treatment of high-risk coronary heart disease.Methods From January 2016 to January 2018,108 patients with high-risk coronary heart disease(CHD)were enrolled in the study.They were divided into observation group(54 cases)and control group(54 cases)according to the patient's hospital single and double number.The observation group was given OPCABG.The control group was given extracorporeal coronary artery bypass grafting(CABG);The surgical outcomes,complications,and prognosis were compared between the two groups.Results The operation time(3.56±0.83)h,the number of bridge vessels(2.97±0.24),the arterial bridge usage rate 100%,the number of distal anastomosis of the venous bridge(3.36±0.47),the rate of secondary thoracotomy 1.85%,tracheotomy rate 5.56%,left ventricular ejection fraction(LVEF)(53.64±7.89)%,N-terminal B-brain natriuretic peptide precursor(NT-proBNP)(425.43±68.21)μg/L of the observation group and control group[(3.82±0.91)h,(2.95±0.26)个,100%(3.54±0.56)个,9.26%,9.26%,(52.76±8.14)%,(432.16±74.45)μg/L]had no significant difference(P>0.05);The transfusion volume(693.24±87.36)mL,hospitalization days(2.23±0.54)d and ICU hospitalization days(14.67±4.85)d of the observation group were significantly lower than those of the control group[(952.18±106.74)mL,(3.56±0.72)d,(18.86±6.52)d](P<0.05).The incidence of complications of brain,liver and kidney injury in the observation group(0.00%)was significantly lower than that in the control group(7.41%)(P<0.05).After 16 months of follow-up,there was no significant difference between the prognosis of the observation group and the control group(P>0.05).Conclusion OPCABG has a good surgical effect in high-risk coronary heart disease applications,which can significantly reduce the amount of blood transfusion,hospitalization and ICU hospitalization,and reduce the incidence of complications.

关 键 词：OPCABG 高危冠心病 疗效 安全性 

分 类 号：R541.4[医药卫生—心血管疾病]