非体外循环下冠状动脉旁路移植术对左主干病变的效果及远期预后观察  

Effect and long-term prognosis of off-pump coronary artery bypass grafting on left main disease

作　　者：李连冲[1] 胡振东[1] 杨宏伟 Li Lianchong;Hu Zhendong;Yang Hongwei(Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473058,China)

机构地区：[1]南阳医学高等专科学校第一附属医院心脏大血管外科,河南南阳473058

出　　处：《中国实用医刊》2021年第24期30-33,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨非体外循环下冠状动脉旁路移植术(OPCAB)对左主干病变的效果,并观察其远期预后。方法抽取2016年1月至2018年1月南阳医学高等专科学校第一附属医院收治的冠状动脉左主干病变患者86例,依据不同方法分为观察组43例与对照组43例。观察组患者采用OPCAB术治疗,对照组患者采用体外循环下冠状动脉旁路移植术(ONCAB)术治疗。比较两组手术时间和远端吻合口数变化,术后指标(包括机械通气时间、入住ICU时间、硝酸甘油用量和引流量),术后并发症情况;随访3年再发心肌梗死和再次经皮冠状动脉介入治疗(PCI)处理,死亡情况(包括因心脏时间和心脏外事件死亡情况)。结果观察组手术时间短于对照组,远端吻合口数少于对照组(P<0.05)。观察组机械通气时间和入住ICU时间短于对照组,且硝酸甘油用量和引流量少于对照组(P<0.05)。观察组术后并发症(9.30%)少于对照组(27.91%),P<0.05。两组随访3年,再发心肌梗死和再次PCI处理比较,P>0.05。观察组随访3年总病死率低于对照组(P<0.05)。结论OPCAB对左主干病变患者效果良好,术后并发症少,且远期预后良好。Objective To investigate the effect of off-pump coronary artery bypass grafting(OPCAB)on left main disease and the long-term prognosis.Methods A total of 86 patients with left main lesions in the First Affiliated Hospital of Nanyang Medical College from January 2016 to January 2018 were selected,and divided into an observation group of 43 cases and a control group of 43 cases according to different methods.Patients in the observation group were treated with OPCAB,and patients in the control group were treated with coronary artery bypass grafting(ONCAB)under cardiopulmonary bypass.The operation time and the number of distal anastomoses were compared between the two groups,and the postoperative indicators(including mechanical ventilation time,ICU time,nitroglycerin dosage and drainage)and postoperative complications;follow-up for 3 years recurring myocardial infarction and re-percutaneous coronary intervention(PCI)treatment,death(including death due to cardiac time and extra-cardiac events).Results The operation time in the observation group was shorter than that in the control group,and the number of distal anastomoses was less than that in the control group(P<0.05).The mechanical ventilation time and ICU stay in the observation group were shorter than those in the control group,and the amount of nitroglycerin and drainage volume were lower than those in the control group(P<0.05).Postoperative complications(9.30%)in the observation group were less than that in the control group(27.91%),P<0.05.The recurrence of myocardial infarction and re-PCI treatment for 3 years of follow-up were compared between the two groups,P>0.05.The total mortality rate of the observation group was lower than that of the control group during the 3-year follow-up(P<0.05).Conclusions OPCAB has a good effect on patients with left main disease,few postoperative complications,and good long-term prognosis.

关 键 词：心血管疾病 非体外循环下冠状动脉旁路移植术 左主干病变 远期预后 

分 类 号：R654.2[医药卫生—外科学]