非接触与裸取大隐静脉在糖尿病冠状动脉移植围术期疗效对比  

Comparative analysis of no-touch method and conventional great saphenous vein extraction method in coronary artery bypass grafting in diabetic patients

作　　者：董志欢 王利敏 曹向戎[3] 李锐[1] 李忠辉[1] 李振江 李良[1] 杨建 郭海平[1] LI Yanzhen DONG Zhihuan;WANG Limin;CAO Xiangrong;LI Rui;LI Zhonghui;LI Yanzhen;LI Zhenjiang;LI Liang;YANG Jian;GUO haiping(Department of Cardiac Surgery The First Hospital of Handan,Handan 056000,China)

机构地区：[1]邯郸市第一医院心脏外科,056000 [2]河北工程大学医学院 [3]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

出　　处：《心肺血管病杂志》2023年第8期825-828,849,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：河北省高等学校科学技术研究项目(QN2022002);邯郸市科学技术研究与发展计划项目(21422083310、21422083048)。

摘　　要：目的:比较在冠心病合并糖尿病患者中常规获取与非接触(No-touch)获取大隐静脉桥血管在冠状动脉旁路移植术(coronary artery bypass grafting, CABG)中的应用效果。方法:将2020年1月至2021年12月,邯郸市第一医院就诊的88例冠心病合并糖尿病患者随机分为常规组(47例)和No-touch组(41例)。No-touch组使用No-touch技术获取大隐静脉桥血管,常规组采用常规切口采集大隐静脉。比较两组围手术期相关指标及术后并发症情况。结果:两组手术时间、术后48h引流量、呼吸机辅助通气时间、住院时间等,差异均无统计学意义(P>0.05)。两组患者术后低心排血量综合征、死亡、心房颤动、中风、心肌梗死、术后应用主动脉内球囊反搏(intra-aortic balloon pump,IABP)、切口感染发生率等均差异无统计学意义(P>0.05)。结论:在冠心病合并糖尿病患者CABG术中,No-touch技术获取大隐静脉桥血管与常规切口法获取具有同样的安全性,不会增加手术风险,可推广使用。Objective:To compare the application effect of conventional acquisition and No-touch acquisition of great saphenous vein bridge vessel in coronary artery bypass grafting(CABG)in patients with coronary heart disease and diabetes.Methods:A total of 88 patients with coronary heart disease and diabetes who under-went CABG in our hospital from January 2020 to December 2021 were selected in this study.They were randomly divided into control group(n=47)and No-touch group(n=41).�Patients in No-touch group were treated with No-touch technique to obtain the great saphenous vein bridge,while patients in conventional group used the conventional incision to collect the great saphenous vein.The perioperative indexes and postoperative complications were compared between the two groups.Results:There was no significant difference in operation time,postoperative 48h drainage volume,ventilator-assisted ventilation time and hospital stay between the two groups(P>0.05).There was no difference in the incidence of postoperative low cardiac output syndrome,death,atrial fibrillation,cerebral infarction,myocardial infarction,postoperative intra-aortic balloon pump(IABP)application and incision infection between 2 groups(P>0.05).Conclusions:For patients with coronary heart disease complicated with diabetes,the No-touch technique to obtain the great saphenous vein bridge vessel has the same safety as the conventional incision method,so it can be widely used.

关 键 词：冠状动脉旁路移植术 No-touch技术 大隐静脉 冠心病 糖尿病 

分 类 号：R54[医药卫生—心血管疾病]