冠状动脉旁路移植术桥血管的选择研究进展  

Advances in the selection of bridge vessels for coronary artery bypass grafting

作　　者：史坤(综述) 夏宇(审校) SHI Kun;XIA Yu(Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou,CHINA)

机构地区：[1]遵义医科大学附属医院胸心外科,贵州遵义563000 [2]遵义医科大学附属医院心脏大血管外科,贵州遵义563000

出　　处：《海南医学》2022年第6期790-793,共4页Hainan Medical Journal

摘　　要：冠状动脉旁路移植术(CABG)是治疗严重冠心病(如左主干病变、多支病变等血管狭窄>70%)最有效的治疗方法。选择适合的桥血管是决定搭桥手术效果和保证良好预后的重要因素之一。虽然有数据显示动脉桥优于静脉桥,但由于动脉桥受年龄限制、易痉挛、易受竞争血流影响、技术难度相对较高等多因素影响,多根/全动脉移植在临床上受到限制。目前,大隐静脉移植仍是心脏冠脉移植手术中使用最多的桥血管。由于目前对桥血管的最佳选择尚未达成共识,因此本文对CABG中主要推荐的桥血管的研究进展及目前移植血管主要选择的趋势和证据作一综述,为临床冠脉搭桥时桥血管的选择提供理论依据。Coronary artery bypass grafting(CABG) is the most effective treatment for severe coronary heart disease(such as left main coronary artery disease, multivessel disease and other coronary artery stenosis>70%). The choice of the appropriate bridge vessel is one of the most important factors in determining the outcome of bypass grafting and ensuring a good prognosis. Although there are data showing that arterial bridges are superior to venous bridges, multiple/whole arterial grafts are clinically limited due to multiple factors such as age restriction, susceptibility to spasm, vulnerability to competing blood flow, and relative technical difficulty of arterial bridges. At present, the saphenous vein graft is still the most used bridge vessel in CABG. Because there is no consensus on the optimal choice of bridge vessel, this article provides a review of the research progress on the main recommended bridge vessels in coronary artery bypass grafting and the current trends and evidence on the main choices of graft vessels, and provides a theoretical basis for the choice of bridge vessels in clinical coronary artery bypass grafting.

关 键 词：冠状动脉旁路移植术 动脉桥 静脉桥 桥血管的选择 第二血管桥 

分 类 号：R654.2[医药卫生—外科学]