冠状动脉杂交手术与非体外循环冠状动脉旁路移植术-倾向性评分匹配对比研究  

Hybrid coronary revascularization and off-pump coronary artery bypass surgery: a comparative study of propensity score matching

作　　者：李光[1] 张继超 刘硕[1] 张帅 杨昭 尤斌[1] LI Guang;ZHANG Jichao;LIU Shuo;ZHANG Shuai;YANG Zhao;YOU Bin(Deparment of Cardiovascular Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

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

出　　处：《心肺血管病杂志》2022年第6期653-656,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:利用倾向性评分匹配减少冠状动脉杂交手术(HCR)与非体外循环冠状动脉旁路移植(CABG)术治疗的偏倚和混杂变量的影响,评价HCR术与非体外循环CABG术的效果差异。方法 :选取2021年1月至2021年10月,在我院行冠心病外科治疗的患者218例,其中HCR组52例,CABG组166例,利用倾向性评分的研究方法进行病例匹配,找到与HCR组病例匹配度最高的52例CABG组病例,并进行相应的对比研究。其中HCR组共计52例,男性39例,女性13例,年龄(62.6±9.1)岁;CABG组共计52例,男性43例,女9例,年龄(59.7±9.0)岁。结果 :两组的手术时间、术后辅助设备的使用情况、术后LVEF、术后红细胞输注量、术后血浆输注量差异无统计学意义。但在术后呼吸机使用时间[17.00(14.50, 21.50)vs. 18.75(15.50,22.50)h]、术后第一天引流量[260(135, 450) vs. 300(185, 500)mL]以及术后住院时间[[5.0(5.0,6.0)vs. 6.0(5.0,8.0)d]等方面,HCR组具有明显的优势。结论 :与非体外循环CABG术相比,HCR术具有很好的优势,同时十分安全、有效。Objective: To evaluate the effect difference between hybrid coronary revascularization(HCR) and off-pump coronary artery bypass grafting(CABG), balance the confounding factors between HCR and off-pump CABG by propensity score match. Methods: 218 patients with coronary heart disease who underwent surgical treatment in our hospital from January 2021 to October 2021 were selected, including 52 cases in the HCR group and 166 cases in the CABG group. By the method of propensity score match, 52cases in the CABG group that best matched with the HCR group were found for comparative study. There were 52 cases in the HCR group, 39 males and 13 females, aged(62.6 ± 9.1) years;There were 52 cases in the CABG group, 43 males and 9 females, aged(59.7 ± 9.0) years. Results: There was no significant difference in operation time, use of postoperative auxiliary equipment, postoperative cardiac ejection fraction, postoperative red blood cell transfusion and postoperative plasma transfusion between HCR group and CABG group. The time of ventilator [17.00(14.50, 21.50)vs. 18.75(15.50, 22.50)H], the drainage volume on the first day [260(135, 450) vs. 300(185, 500)mL] and the postoperative hospital stay [5.0(5.0,6.0)vs. 6.0(5.0,8.0)d] were significantly decreased in the HCR group. Conclusion: Compared with off-pump CABG, HCR has many advantages, and it is safe and effective.

关 键 词：冠状动脉杂交手术 冠状动脉旁路移植术 倾向性评分匹配研究 

分 类 号：R54[医药卫生—心血管疾病]