应用桡动脉序贯吻合行冠状动脉旁路移植术的疗效  

Assessment of postoperative outcomes of radial artery as a sequential graft in coronary artery bypass grafting

作　　者：马小龙[1] 孔晴宇[1] 梁林[1] 肖巍[1] 柳佳吉 董然[1] 王坚刚[2] 迟立群[1] Ma Xiaolong;Kong Qingyu;Liang Lin;Xiao Wei;Liu Jiaji;Dong Ran;Wang Jiangang;Chi Liqun(Department of Minimally Invasive Cardiac Surgery,Anzhen Hospital Affiliated to Capital University of Medial Sciences,Beijing 100029,China;Department of Cardiac Valve Surgery,Anzhen Hospital Affiliated to Capital University of Medial Sciences,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院微创心脏外科中心,北京100029 [2]首都医科大学附属北京安贞医院瓣膜外科中心,北京100029

出　　处：《中华胸心血管外科杂志》2022年第2期92-95,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨冠心病患者应用桡动脉序贯吻合法行冠状动脉旁路移植术(CABG)的疗效。方法回顾性分析北京安贞医院2020年4月至2020年12月期间109例接受桡动脉或大隐静脉序贯吻合CABG术的冠心病患者临床资料,其中男86例,女23例;年龄39~79岁,平均(61.1±8.0)岁。根据移植血管材料分为桡动脉组(47例)和大隐静脉组(62例),比较分析两组术前基线资料、手术治疗、术后并发症及术后指标。结果两组患者在年龄、性别、合并症、超声心动图结果、移植血管指标、冠状动脉造影结果、手术方式(停跳或不停跳、乳内使用、远端吻合口数目和分布)方面差异均无统计学意义(P>0.05)。两组在ICU滞留时间、术后住院天数以及术后24 h胸腔引流量方面差异无统计学意义(P>0.05)。桡动脉组术后脑血管事件、术后感染和二次开胸发生率均高于大隐静脉组;大隐静脉组在术后心肌梗死、术后室性心律失常和术后主动脉内球囊反搏辅助发生率方面高于桡动脉组,但差异均无统计学意义(P>0.05)。结论CABG术中应用桡动脉作为旁路移植血管且采用序贯吻合法,并未增加术后并发症发生风险,患者术后恢复顺利。Objective To explore the perioperative effect of radial artery as a sequential graft in coronary artery bypass grafting(CABG).Methods The clinical data and perioperative complications of 109 patients,who underwent radial artery(RA)or great saphenous vein(SVG)as a sequential graft during CABG from April 2020 to December 2020 in Beijing Anzhen Hospital,were analyzed,there were 86 males and 23 females,aged from 39 to 79 years,with an average of(61.1±8.0)years old.According to the graft materials,they were divided into the RA group(n=47)and SVG group(n=62).Results There were no significant differences between the two groups in age,gender,comorbidities,echocardiographic results,transplant vascular indexes,coronary angiography results,and operation methods(on-pump or off-pump,use of left internal mammary artery,number and distribution of distal anastomoses)(P>0.05).There were also no significant difference between the two groups in ICU stay,postoperative hospital stay and drainage with 24 hours after CABG(P>0.05).The incidence of postoperative cerebrovascular events,postoperative infection and secondary thoracotomy in the RA group were higher than that in the SVG group.The incidence of myocardial infarction,postoperative ventricular arrhythmia and postoperative IABP assistance in the SVG were higher than that in the RA group,but the difference was not statistically significant(P>0.05).Conclusion The application of radial artery as a sequential graft during CABG does not increase the risk of perioperative complications,and the patients recover smoothly.

关 键 词：冠状动脉旁路移植术 桡动脉 序贯吻合 围手术期 

分 类 号：R654.2[医药卫生—外科学]