基于SYNTAX积分的冠状动脉病变复杂程度对微创或常规冠状动脉旁路移植手术效果影响的研究  

Complexity of coronary artery lesions on the effect of minimally invasive or conventional bypass surgery based on SYNTAX score

作　　者：梁林[1] 柳佳吉 迟立群[1] 孔晴宇[1] 尤斌[1] 肖巍[1] 马小龙[1] Liang Lin;Liu Jiaji;Chi Liqun;Kong Qingyu;You Bin;Xiao Wei;Ma Xiaolong(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]北京市心肺血管疾病研究所首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中华胸心血管外科杂志》2022年第5期281-286,共6页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市科协金桥工程种子资金(ZZ19006);首都临床诊疗技术研究及转化应用项目(Z201100005520086)。

摘　　要：目的探讨基于SYNTAX积分(SS)的冠状动脉病变复杂程度对微创或常规冠状动脉旁路移植围手术期手术效果的影响。方法2017年1月至2020年1月安贞医院微创心外中心医疗组接受不停跳下冠状动脉旁路移植术(OPCABG)患者共760例。男596例,女164例;年龄28~85岁,平均(60.88±9.36)岁。按手术方式分为微创冠状动脉旁路移植术(MICS CABG)379例(微创组),正中开胸组381例(常规组)。本研究对两种手术方式的冠状动脉旁路移植患者进行SS评分分组,进而分别对比高、中、低分值区间两组围手术期数据,初步分析SS各分值段患者接受两种术式的围手术期比较。结果SS低积分组包括微创组96例,常规组11例;SS中积分组微创组98例,常规组54例;SS高积分组微创组185例,常规组316例。3个区间中SS值微创组和常规组差异均无统计学意义,术前资料中年龄、性别、体质量指数、高血压、糖尿病、脑血管CT异常病史、肺疾病、烟酒史差异无统计学意义。3组微创冠状动脉旁路移植数量均明显少于常规组。SS低积分组微创和常规手术时长接近,SS中、高积分组微创手术时长均大于常规组。术后资料中微创组术后第1天引流在SS中、高积分组少于常规手术,在SS低、中积分组住院天数少于常规组。围手术期30天MACCE及辅助设备置入比例差异均无统计学意义。结论同等级SS积分对常规CABG或MICS CABG的围手术期临床效果无明显影响,冠状动脉病变的复杂程度并非选择微创或常规冠状动脉旁路移植的决定性依据。Objective To investigate the influence of the complexity of coronary artery disease based on SYNTAX score(SS)on the effect of minimally invasive or conventional bypass surgery.Methods From January 2017 to January 2020,the medical group of the Minimally Invasive Cardiac Surgery Center of Beijing Anzhen Hospital received a total of 760 patients undergoing off-pump coronary artery bypass grafting(OPCABG)surgery,including 596 males and 164 females.28-85 years old,with an average of(60.88±9.36)years old.379 cases underwent minimally invasive coronary artery bypass grafting(MICS CABG)(minimally invasive group)and 381 cases underwent median thoracotomy CABG(conventional group).In this study,according to the SS,patients of both groups were divided into 3 levels,and then the perioperative data of the two sets of high,medium,and low score intervals were compared respectively,and a preliminary analysis of the perioperative data for patients in each SS score section was performed.Results There was no significant difference in the SS value between the minimally invasive group and the conventional group in the three intervals.There was no statistical difference in preoperative data including age,sex ratio,body mass index,hypertension,diabetes,abnormal head CT history,lung disease,history of tobacco and alcohol.The number of minimally invasive bypasses in the three groups was significantly less than that of the conventional group.The duration of minimally invasive surgery in the SS low score group was similar to that of conventional surgery,and the duration of minimally invasive surgery in the SS medium and high score group was longer than that in the conventional group.The hospital stay in the SS low and middle score group was less than that of the conventional group.There was no statistical difference in the proportion of MACCE and auxiliary equipment implantation in the 30-day perioperative period.Conclusion In the same grade of SS group,there is no significant difference on the perioperative clinical effect between convent

关 键 词：微创 SYNTAX积分 不停跳冠状动脉旁路移植术 

分 类 号：R654.2[医药卫生—外科学]