全动脉冠状动脉旁路移植术近中期临床效果分析  

Total arterialized coronary artery bypass grafting:short-and mid-term clinical outcomes

作　　者：邬子珉 罗程[1] 郑宝石[1] Wu Zimin;Luo Cheng;Zheng Baoshi(Department of cardiothoracic Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530000,China)

机构地区：[1]广西医科大学第一附属医院心胸外科,南宁530000

出　　处：《中华胸心血管外科杂志》2023年第8期461-465,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(82060082);广西心脑血管疾病防治精准医学重点实验室开放课题(GXXNXG202104)。

摘　　要：目的评价冠心病患者应用全动脉冠状动脉旁路移植术(coronary artery bypass grafting,CABG)的可行性和安全性以及近中期疗效。方法回顾性分析2016年1月至2021年7月期间广西医科大学第一附属医院行CABG治疗的100例患者的临床资料,其中动脉组(TACR组)50例患者接受左侧胸廓内动脉+桡动脉旁路移植手术,常规组(NCR组)50例患者接受左侧胸廓内动脉+大隐静脉旁路移植手术。对两组患者围手术期以及术后随访(3个月、6个月、1年、5年)的临床资料进行比较分析。结果围手术期数据对比,TACR组在手术时间和术后24h引流量较NCR组高,术后高敏肌钙蛋白T峰值低于NCR组,差异有统计学意义。机械通气时间与围手术期病死率等方面组间差异无统计学意义;随访数据在术后3、6个月时的左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径与再发心肌梗死例数差异无统计学意义;TACR组术后1、5年随访时LVEF优于NCR组,差异有统计学意义。结论本中心开展全动脉冠状动脉旁路移植术临床效果满意。并发症发生率低,安全可行。Objective To evaluate the safety of total artery coronary artery bypass grafting(CABG)in patients with coro-nary heart disease and the short-and mid-term clinical outcomes.Methods A retrospective analysis of the clinical data of 100 patients who underwent CABG treatment in the First Affiliated Hospital of Guangxi Medical University from January 2016 to July 2021.Of these,50 patients were selected for comparison(TACR)with the left internal thoracic artery and radial artery(RA)as grafts.However,the left internal thoracic artery and the great saphenous vein were used as grafts in other 50 patients were selected as controls(NCR).The clinical data of preoperative,perioperative,and postoperative(3 months,6 months,1 year and 5 years)for two groups were compared.Results In the perioperative period,TACR group was inferior to the control in both operation time and 24 h postoperative drainage.But the peak value of hypersensitive troponin T was lower than that of NCR.There was no significant difference between the two groups in terms of mechanical ventilation time and perioperative mor-tality.There was no significant difference between the two groups in terms of left ventricular ejection fraction(LVEF),recur-rent angina,left ventricular end-diastolic diameter and recurrent myocardial infarction at 3 and 6 months after operation.LVEF in TACR was better than that in NCR at 1 year and 5 years postoperatively.Conclusion The clinical effect of CABG with RA as bridge vessel carried out in our center is obvious.TACR is safe and feasible due to its good mid-term efficacy and is not like-ly to cause postoperative complications.

关 键 词：冠心病 全动脉化 冠状动脉旁路移植术 桡动脉 

分 类 号：R654.2[医药卫生—外科学]