全动脉化冠脉旁路移植术对冠心病患者术后早期预后的影响  

Effect of total arterial coronary artery bypass grafting on the early prognosis of patients with coronary heart disease after coronary artery bypass surgery

作　　者：刘戈[1] 施超[1] LIU Ge;SHI Chao(Department of Cardic Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院心脏外科,安徽蚌埠233004

出　　处：《山东第一医科大学（山东省医学科学院）学报》2022年第2期130-134,共5页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

基　　金：安徽省科技攻关项目(1804H08020290);蚌埠医学院转化医学重点专项(BYTM2019041)。

摘　　要：目的探讨体外循环下行全动脉化冠状动脉旁路移植术对患者围手术期临床疗效与术后早期预后的影响。方法58例行体外循环下全动脉化冠脉旁路移植手术的冠心病患者为A组,52例行体外循环下常规冠脉旁路移植手术的冠心病患者为B组。比较两组患者围手术期的相关数据,评估手术疗效,随访并记录患者术后12个月内心血管不良事件(major adverse cardiovascular events,MACEs)发生率。结果与B组相比,术后A组患者的机械通气时间及术后ICU入住时间较B组有明显差异(P<0.05)。术中A组桡动脉桥平均血管流量高于B组静脉桥,差异具有统计学意义(P<0.05)。两组术后患者转出ICU时左心射血分数比较,差异具有统计学意义(P<0.05)。B组患者术后12个月MACEs发生的比例高于A组,差异均具有统计学意义(P<0.05)。结论全动脉化冠状动脉旁路移植术对冠心病患者安全可行,具有良好的短期临床效果。Objective:To examine the early prognosis and perioperative clinical efficacy of total arterial coronary artery bypass grafting.Methods:Fifty-eight patients with coronary heart disease undergoing total arterialized coronary artery bypass grafting under cardiopulmonary bypass were classified as group A,and 52 patients with routine coronary artery bypass grafting under cardiopulmonary bypass were classified as group B.The data on perioperative periods in two groups of patients were compare,surgical efficacy was evaluated,and the incidence of cardiovascular adverse events(MACEs)in the 12 months after surgery were followed up and recorded.Results:Compared with Group B,the mechanical ventilation time and postoperative ICU occupancy time of patients in Group A were significantly different from those in Group B,and the difference was statistically significant.(P<0.05)There were significant differences in left ventricle blood fraction between the two groups when the patients were transferred out of the ICU after surgery,and the differences were statistically significant.(P<0.05)The proportion of cardiovascular adverse reactions occurred in Group B patients in 12 months after surgery was higher than that of Group A,and the differences were statistically significant(P<0.05).Conclusion:Total arterial coronary bypass grafting is safe and feasible during perioperative period,and has good shortterm clinical effect.

关 键 词：全动脉化 冠心病 冠状动脉旁路移植术 

分 类 号：R654.2[医药卫生—外科学]