急诊冠状动脉旁路移植术临床疗效分析  

Analysis of clinical effect of emergency coronary artery bypass grafting

作　　者：李洪利[1] 李杨[1] 刘燕晖[1] 尚学斌[1] 齐德林 冯磊 李超 Li Hongli;Li Yang;Liu Yanhui;Shang Xuebin;Qi Delin;Feng Lei;Li Chao(Department of Cardiovascular Surgery,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;不详)

机构地区：[1]首都医科大学宣武医院心脏外科,北京100053

出　　处：《中国循证心血管医学杂志》2021年第4期452-454,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：首都医科大学宣武医院院级课题(XWJL-2019040)。

摘　　要：目的探讨急诊冠状动脉旁路移植术(CABG)对危重症患者的近远期疗效。方法回顾性分析2008至2013年于首都医科大学宣武医院行急诊CABG的冠状动脉粥样硬化性心脏病(冠心病)患者157例,根据术前心电图及高敏肌钙蛋白I(hs-cTnI)是否升高分为急性冠脉综合征组(A组,n=116)和非急性冠脉综合征组(N组,n=41),根据发病至手术时间,将急性冠脉综合征组分为大于12 h组(n=33例),小于12 h组(n=83例)。统计围手术期临床资料及术后2年的随访情况,行组间比较。结果入组患者男性120例,女性37例,平均年龄(68.51±10.45)岁,两组基线资料比较差异无统计学意义(P>0.05),围术期A组死亡13例,死亡率11.2%,N组死亡1例,死亡率2.4%,两组差异有统计学意义(P<0.05)。在围术期监护室入住时间、术后住院天数上N组短于A组,两组差异有统计学意义(P<0.05),N组生存率优于A组,但两者无统计学差异。A组亚组比较,大于12 h组在术后死亡率及ICU天数,术后住院天数上显著升高(P≤0.05)。结论掌握好适应证,急诊CABG作为一种抢救性治疗是安全、有效的,越早手术,术后疗效越好。Objective To explore the short-term and long-term effects of emergency coronary artery bypass grafting(CABG)on critically ill patients.Methods A retrospective analysis of 157 patients with coronary heart disease who underwent emergency CABG in our hospital from 2008 to 2013.According to the preoperative electrocardiogram and whether High-sensitivity cardiac troponin I(High-sensitivity cardiac troponin I hs-cTnI)is elevated,they are divided into acute coronary syndrome group(group A,116 cases)and non-acute coronary syndrome group(group N),41 cases.According to the time from onset to operation,the acute coronary syndromes were divided into 33 cases in the group greater than 12 hours and 83 cases in the group less than 12 hours.The clinical data during the perioperative period and the follow-up 2 years after the operation were collected,and comparisons between groups were made.Results There were 120 males and 37 females enrolled in the group,with an average age of(68.51±10.45)years.There was no significant difference in baseline data between the two groups(P>0.05).There were 13 deaths in group A during the perioperative period,and the mortality rate was 11.2%.1 case died in group N,the mortality rate was 2.4%,the difference between the two groups was statistically significant(P<0.05).In the perioperative care unit,the length of stay in the intensive care unit and the number of postoperative hospital stays in group N were shorter than group A.The difference between the two groups was statistically significant(P<0.05).The survival rate of group N was better than group A,but there was no statistical difference.Compared with the subgroups of group A,the postoperative mortality,ICU days,and postoperative hospital stays in the group greater than 12 hours were significantly higher(P≤0.05).Conclusion Under the premise of mastering the indications,emergency CABG as a rescue treatment is safe and effective,and the earlier the surgery,the better the postoperative effect.

关 键 词：急诊冠状动脉旁路移植术 急性冠状动脉综合征 围术期 死亡 

分 类 号：R318[医药卫生—生物医学工程]