全动脉化冠状动脉旁路移植术中右侧乳内动脉桥与桡动脉桥的选择与评估  

Selection and evaluation of right internal mammary and radial artery bridges in total arterialized coronary artery bypass grafting

作　　者：唐茂华(综述) 夏宇(审校) TANG Mao-hua;XIA Yu(Department of Cardiovascular Surgery,the Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,CHINA)

机构地区：[1]遵义医科大学附属医院心血管外科,贵州遵义563000

出　　处：《海南医学》2021年第8期1048-1052,共5页Hainan Medical Journal

摘　　要：冠状动脉相关疾病已成人类心血管疾病死亡病因之首,对于内科介入治疗及药物的治疗无明显效果的冠心病患者,冠状动脉旁路移植术能达到缓解症状、延长患者生存率的目的。左侧乳内动脉桥移植到左前降支的策略被认为是冠脉重建的金标准,而实际临床工作中患者常为冠脉多支血管病变,往往需要多根血管桥,右侧乳内动脉和桡动脉是冠脉多支血管病变患者中除左侧乳内动脉外应用最广泛的动脉导管。全动脉化旁路移植术第二血管桥的选择尚无定论。本文力求在全动脉化冠状动脉旁路移植术中,对右侧乳内动脉及桡动脉血管桥的组织学及解剖特点、临床研究进行概述,以期为患者个体化治疗的决策提供诊疗帮助。Coronary artery related diseases have become the leading cause of death of cardiovascular diseases in human beings.For patients with coronary heart disease who have no obvious effect of interventional therapy and drug treatment,coronary artery bypass grafting can achieve the purpose of alleviating symptoms and prolonging the survival rate.Transplanting left internal mammary artery(LIMA)bypass to left anterior descending artery is considered a gold standard of coronary artery reconstruction.However,the patients often have multiple coronary artery disease in actual clinical work,which often require more blood vessel bridge,and right internal mammary artery and radial artery are the most widely used catheters in patients with multivessel coronary artery disease except left internal mammary artery.The choice of second vascular bridge in total arterialized bypass grafting has not been determined.This article tries to summarize the histological and anatomical features and clinical studies of right internal mammary artery and radial artery bridge during the total arterialized coronary artery bypass grafting,in order to provide diagnostic and treatment assistance for the decision of individualized treatment.

关 键 词：冠状动脉旁路移植术 左侧乳内动脉 右侧乳内动脉 围手术期胸骨并发症 桡动脉 第二动脉桥 

分 类 号：R654.2[医药卫生—外科学]