非体外循环冠状动脉旁路移植术对左心功能不全预后的影响分析  

Effect of off-pump coronary artery bypass grafting on prognosis of left heart dysfunction

作　　者：胡国智[1] HU Guozhi(Department of Cardiac Surgery,Wuhan Asian Heart Hospital,Wuhan430022,China)

机构地区：[1]武汉亚洲心脏病医院心外科,湖北武汉430022

出　　处：《中国现代医生》2022年第4期60-63,共4页China Modern Doctor

摘　　要：目的探讨非体外冠状动脉旁路移植术治疗左心功能不全的预后影响。方法回顾性选取2018年3月至2020年12月在武汉亚洲心脏病医院就诊的100例冠心病合并心功能不全患者,其中接受OPCABG治疗48例与接受CCABG治疗52例。分析患者术后NT-proBNP水平及心功能变化,比较患者的临床指标和手术相关指标变化及预后情况。结果术后OPCABG组左心室舒张末期内径、NT-proBNP水平下降,左心室射血分数升高,差异有统计学意义(P<0.05);OPCABG组呼吸机使用时间比CCABG组使用时间短,出血量比CCABG组少,差异有统计学意义(P<0.05);两组术后住院时间、移植血管支数比较,差异无统计学意义(P>0.05);OPCABG组ICU治疗时间、机械通气时间及活性药物应用时间显著短于CCABG组,差异有统计学意义(P<0.05),两组患者心律失常、围术期心肌缺血、手术切口愈合不良占比比较,差异无统计学意义(P>0.05)。结论非体外循环冠状动脉旁路移植术和体外循环冠状动脉旁路移植术对患者心功能水平的保护均有改善,OPCABG组的改善情况和疗效优于CCABG组,安全性更高。Objective To investigate the effect of off-pump coronary artery bypass grafting(OPCABG)on the prognosis of left heart dysfunction.Methods A total of 100 patients with coronary heart disease complicated with cardiac dysfunction who were admitted to Wuhan Asian Heart Hospital from March 2018 to December 2020 were retrospectively selected,including 48 patients who received OPCABG treatment and 52 patients who received common coronary artery bypass grafting(CCABG)treatment.The levels of postoperative NT-proBNP and changes in cardiac function were analyzed,and the changes of clinical indicators and operation-related indicators and prognosis of the patients were compared.Results In the OPCABG group,compared with before surgery,the postoperative left ventricular end-diastolic diameter and NT-proBNP level were decreased,and the left ventricular ejection fraction was increased,with statistically significant differences(P<0.05).In the OPCABG group,the duration of ventilator use was shorter than that in the CCABG group,and the amount of blood loss was less than that in the CCABG group,with statistically significant differences(P<0.05).There was no significant difference in postoperative hospital stay and the number of grafted vessels between the two groups(P>0.05).The ICU treatment time,mechanical ventilation time and active drug application time in the OPCABG group were significantly shorter than those in the CCABG group,and the differences were statistically significant(P<0.05).No statistically significant differences were observed in the percentage of arrhythmia,perioperative myocardial ischemia and bad wound healing between the two groups(P>0.05).Conclusion Both off-pump coronary artery bypass grafting and common coronary artery grafting improved the protection of cardiac function level in patients,and the improvement and therapeutic efficacy of the OPCABG group were better than those of the CCABG group,with higher safety in the OPCABG group.

关 键 词：非体外循环冠状动脉旁路移植术 体外循环冠状动脉旁路移植术 心功能不全 预后 

分 类 号：R654.2[医药卫生—外科学]