左进胸微创多支冠状动脉搭桥术治疗冠心病的临床应用  

Clinical application of minimally invasive cardiac surgery for coronary artery bypass grafting through left thoracotomy in the treatment of coronary heart disease

作　　者：樊扬名 曹静 葛建军 FAN Yangming;CAO Jing;GE Jianjun(Department of Cardiac Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China;Anhui Institute of Cardiovascular Diseases,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科,安徽合肥230001 [2]安徽省心血管病研究所,安徽合肥230001

出　　处：《安徽医药》2021年第9期1779-1782,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省自然科学基金面上项目(2008085MH240);2018年度省心血管病研究所第二批科研项目(KF2018008);安徽省科技重大专项(18030801132)。

摘　　要：目的评价分析左进胸微创多支冠状动脉搭桥术(minimally invasive cardiac surgery for coronary artery bypass grafting,MICS CABG)治疗冠心病的效果及其可行性和安全性。方法选取自2020年4月至2021年3月以来于中国科学技术大学附属第一医院开展MICS CABG的冠心病病人10例进行回顾性分析。对所有病人术前基本信息、术中资料如搭桥数量及术后相关资料和并发症等进行分析,总结MICS CABG的效果和可行性。结果10例病人行MICS CABG术共搭桥23支,平均2.3支/例。且病人无术中转正中开胸、主动脉球囊反搏植入;术后转回监护室治疗,无二次手术发生。术后呼吸机时间中位数为9 h,重症监护室停留时间中位数为47.75 h。术后首日引流量中位数为275 mL,输血病人为3例(30%)。住院期间未发生房颤、肾功能损伤、主要心血管不良事件、术后死亡以及术后脑梗死等事件。术后住院时间中位数为9.5 d。结论对于合适的病人,在配合围手术期精细管理的基础下,MICS CABG是治疗冠心病安全有效的方法,且预后良好。Objective To evaluate the efficacy,feasibility and safety of minimally invasive cardiac surgery for coronary artery bypass grafting(MICS CABG)through left thoracotomy in the treatment of multi-vessel coronary artery disease.Methods Retrospective analysis was performed on 10 patients with coronary artery disease who underwent MICS CABG in The First Affiliated Hospital of University of Science and Technology of China from April 2020 to March 2021.The preoperative basic information,intraoperative data such as bypass number,postoperative data and complications of patients were analyzed to evaluate the effect and feasibility of MICS CABG.Results A total of 23 grafts were performed in 10 patients who underwent MICS CABG with an average of 2.3 grafts per person.There was no person transferred to midline thoracotomy or performed intra-aortic balloon pump(IABP).All patients were transferred to the intensive care unit(ICU)for treatment after surgery with no second operation performed.The median postoperative ventilator time was 9 h,and the median ICU time was 47.75 h.The median drainage volume on the first day after surgery was 275 mL,and 3 patients(30%)received blood transfusion.No atrial fibrillation,renal function impairment,major adverse cardiovascular events,postoperative death or postoperative cerebral infarction occurred during hospitalization.The median postoperative hospital stay was 9.5 days.Conclusion MICS CABG is a safe and effective therapy for coronary artery disease with good prognosis for appropriate patient with fine perioperative management.

关 键 词：冠心病 冠状动脉旁路移植术 非体外循环 冠脉多支病变 左进胸 微创 

分 类 号：R654.2[医药卫生—外科学]