一站式与同期颈动脉支架置入联合非体外循环冠状动脉旁路移植术的对比研究  

A comparative study of one-stop and simultaneous carotid stenting combined with off-pump coronary artery bypass grafting

作　　者：刘长城[1] 薛源[1] 王世攀 高铭鑫[1] 王建涛[2] 李海洋[1] LIU Changcheng;XU Yuan;WANG Shipan;GAO Mingxin;WANG Jiantao;LI Haiyang(Department 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心外科,100029 [2]首都医科大学附属北京安贞医院神经外科,100029

出　　处：《心肺血管病杂志》2022年第11期1160-1163,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(82070483);北京市医管局临床医学发展专项(XMLX202107)。

摘　　要：目的:比较一站式与同期颈动脉支架置入(CAS)联合非体外循环冠状动脉旁路移植术(OPCABG)治疗冠心病合并严重颈动脉狭窄的安全性和有效性。方法:回顾性分析2016年1月至2022年3月在我院行CAS+OPCABG患者的临床资料。一站式组18例,同期组14例(CAS优先,1d <间隔时间≤7d)。比较两组30d预后,安全终点:出血事件、输血率和24h引流量;预后终点:30d主要不良心脑血管事件(心肌梗死、脑梗死、死亡)。结果:一站式杂交显著缩短术后住院时间(7 vs.11d,P=0.024);与同期组比较,一站式组患者MACCE事件发生率更低(零vs.21.4%)。两组均无严重出血事件,同期组术后输血比例(16.7%vs.42.9%)及24h引流量> 1 000mL比例(11.1%vs.28.6%)均高于一站式组。结论:一站式与同期CAS+OPCABG早期预后相似,但一站式杂交手术存在降低术后输血及MACCE风险趋势。Objective:To compare the safety and efficacy of one-stop and simultaneous carotid artery stenting(CAS) combined with off-pump coronary artery bypass grafting(OPCABG) treating coronary heart disease and severe carotid artery stenosis.Methods:Between January 2016 and March 2022,the clinical data of patients who underwent CAS+OPCABG in our hospital from were retrospectively analyzed.According to operative strategy,patients were divided into the One-stop hybrid group(n=18) and the same period group(CAS) prior to OPCABG,1 day 1 000mL(11.1% vs.28.6%) in the same period group were higher than that in the one-stop group.Conclusions:One-stop and simultaneous CAS+OPCABG have similar early prognosis,but one-stop hybrid surgery tends to reduce the risk of postoperative blood transfusion and MACCE.

关 键 词：颈动脉狭窄 冠心病 冠状动脉旁路移植术 颈动脉支架置入术 

分 类 号：R54[医药卫生—心血管疾病]