冠状动脉旁路移植术中桡动脉与大隐静脉用于右冠状动脉系统的通畅率比较研究  

The patency of radial artery and great saphenous vein bypassed to right coronary artery system in coronary artery bypass grafting-a propensity score matching analysis

作　　者：罗文琦[1] 王子[1] 王怀斌[1] 马玉健[1] 钟鹏 甄文俊[1] 欧阳小康[1] LUO Wen-qi;WANG Zi;WANG Huai-bin;MA Yu-jian;ZHONG Peng;ZHEN Wen-jun;OUYANG Xiao-kang(Department of Cardiovascular Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院心血管外科,国家老年医学中心,中国医学科学院老年医学研究院,北京市100730

出　　处：《中国心血管病研究》2021年第8期722-725,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的对比冠状动脉旁路移植术(coronary artery bypass grafting,CABG)中桡动脉(radial artery,RA)与大隐静脉(great saphenous vein,GSV)作为移植血管在用于右冠状动脉系统的通畅率。方法回顾性分析2012年1月至2020年1月在北京医院心血管外科行CABG后复查冠状动脉CT血管成像(computer tomography angiography,CTA)的患者资料,其中RA用于右冠状动脉系统有34例(RA组),GSV用于右冠状动脉系统86例(GSV组),比较两组患者的资料,并根据性别、年龄、危险因素、合并症、心功能、欧洲心血管手术危险因素评分(EuroSCORE)Ⅱ等基本资料进行倾向评分匹配(Propensity Score Matching,PSM)后,RA组和GSV组各21例入组,分析两组患者围术期各项指标及移植血管通畅情况。结果GSV组患者年龄显著高于RA组[(64.8±9.1)岁比(60.7±9.8)岁,P=0.001],EuroSCOREⅡ评分显著高于RA组[(1.62±1.46)比(0.99±0.53),P=0.001]。PSM后两组间基线资料无显著差异(P>0.05),术中情况及术后并发症发生率无显著差异,GSV组和RA组患者随访时间无显著差异[(12.33±14.47)月比(9.50±13.35)月,P=0.513],RA组的通畅率显著高于GSV组(95.2%比51.7%,P=0.004)。结论RA作为移植血管用于右冠状动脉系统的通畅率显著高于GSV。Objective To evaluate the patency of radial artery and great saphenous vein as grafts bypassed to right coronary artery system in coronary artery bypass grafting(CABG).Methods A retrospective analysis of 120 patients underwent coronary artery computer tomography angiography(CTA)after CABG in the Department of Cardiac Surgery in Beijing Hospital from January 2012 to January 2020(34 patients bypassed to right coronary artery system with RA,86 patients with GSV)was conducted.The baseline data were compared.Based on variables including gender,age,preoperative risk factors,related complication and EuroSCOREⅡ,two matched cohorts were constructed:GSV group and RA group(21 patients were included in each group).Intraoperative and postoperative outcomes and the patency of grafts were analyzed.Results The age of the patients in GSV group was older than RA group[(64.8±9.1)years vs.(60.7±9.8)years,P=0.001]and the patients in GSV group had higher EuroSCOREⅡscore(1.62±1.46 vs.0.99±0.53,P=0.001).After matching,the patients baseline data were nearly balanced between the two groups and there was no significant difference in intraoperative outcomes and incidence of postoperative complications.The patency rate of RA group bypassed to right coronary artery system was higher than GSV group(51.7%vs.95.2%,P=0.004).Conclusion The patency rate of RA is highter than GSV when bypassed to right coronary artery system in CABG.

关 键 词：桡动脉 大隐静脉 右冠状动脉 冠状动脉旁路移植术 倾向评分匹配分析 

分 类 号：R654.2[医药卫生—外科学]