冠状动脉旁路移植术手术方式选择对患者术后早期健康相关生存质量影响的研究  

Study on the influence of the choice of operation mode on the early health-related quality of life of patients after coronary artery bypass grafting

作　　者：赵铁夫[1] 王盛宇[1] 张春晓[1] 张明[1] 陈宏[1] ZHAO Tiefu;WANG Shengyu;ZHANG Chunxiao;ZHANG Ming(CHEN Hong Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科,100029

出　　处：《心肺血管病杂志》2020年第11期1359-1363,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨非体外冠状动脉旁路移植术(OPCAB)与体外循环辅助下冠状动脉旁路移植术(ONCAB)对患者术后早期健康相关生存质量影响。方法:选取2015年1月至2016年12月,北京安贞医院单一手术组对408例患者施行了冠状动脉旁路移植术,根据是否应用体外循环将患者分为两组,OPCAB术组(OP组,n=239):男性161例,年龄(63.64±8.13)岁;ONCAB术组(ON组,n=169):男性115例,年龄(63.75±8.28)岁。应用简明健康调查量表和西雅图心绞痛问卷测评两组患者术前、术后1个月、3个月、6个月、1年、2年和3年的得分。结果:全部病例共失访39例,随访率为90.4%。应用简明健康调查量表测评,两组内各维度均存在差异(P=0.000);组间不同时间测评,OP组术后1个月[(39.75±1.27)vs.(39.12±1.00),F=5.579,P=0.000]和3个月[(39.35±1.09)vs.(38.72±0.93),F=6.145,P=0.000]得分高于ON组,术后2年[(61.37±1.98)vs.(61.83±1.80),F=-2.343,P=0.020]和术后3年[(63.49±1.19)vs.(64.06±1.01),F=-4.890,P=0.000]得分低于ON组。应用西雅图心绞痛问卷测评,组内各维度均存在差异(P=0.000);术后3年OP组[(71.41±4.41)vs.(74.04±4.22),F=-5.915,P=0.000]得分低于ON组。结论:OPCAB术后早期健康相关生存质量优于ONCAB;术后1~2年,生存质量无差别;术后3年,患者健康相关生存质量低于接受ONCAB患者。Objective:To explore the influence of off-pump coronary artery bypass(OPCAB)grafting and on-pump coronary artery bypass grafting(ONCAB)on the early postoperative health-related quality of life.Methods:From January 2015 to December 2016,408 patients underwent coronary artery bypass grafting in the single operation group of Beijing Anzhen Hospital.According to whether to use cardiopulmonary bypass,the patients were divided into two groups:OPCAB group(n=239):161 males,aged(63.64±8.13)years;ONCAB group(n=169):115 males,aged(63.75±8.28)years.The scores of patients in the two groups before and after operation were measured with the concise health questionnaire and Seattle Angina Questionnaire.Results:The follow-up rate was 90.4%.In the 2 group,the OP group’s scores were higher than those in the ON group at 1 month[(39.75±1.27)vs.(39.12±1.00),F=5.579,P=0.000]and 3 months[(39.35±1.09)vs.(38.72±0.93),F=6.145,P=0.000],2 years[(61.37±1.98)vs.(61.83±1.80),F=-2.343,P=0.020]and 3 years after operation[(63.49±1.19)vs.(64.06±1.01),F=-4.890,P=0.000]were lower than those of the ON group.Using Seattle Angina Questionnaire,there were differences in all dimensions within the group(P=0.000);the scores of the OP Group[(71.41±4.41)vs.(74.04±4.22),F=-5.915,P=0.000]were lower than those of the ON group.Conclusions:The early health-related quality of life after OPCAB was better than that after ONCAB.There was no difference in the quality of life after operation 1-2 years;3 years after operation,the health-related quality of life of patients was lower than that of patients undergoing ONCAB.

关 键 词：冠状动脉旁路移植术 非体外冠状动脉旁路移植术 健康相关生存质量 

分 类 号：R54[医药卫生—心血管疾病]