非体外循环下冠状动脉搭桥术的临床疗效分析  

Clinical efficacy of off-pump coronary artery bypass grafting

作　　者：蒋磊[1] JIANG Lei(Department of Cardiovascular Surgery,Henan Provincial Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院心血管外科,郑州450000

出　　处：《医药论坛杂志》2024年第12期1282-1285,共4页Journal of Medical Forum

摘　　要：目的探讨非体外循环下冠状动脉搭桥术的临床疗效。方法选取2017年10月至2019年10月期间在河南省胸科医院进行冠状动脉搭桥手术冠心病患者102例的临床资料。采用随机数字表法将患者分为两组,各51例。观察不同方式手术对患者心肌、心功能指标、不良反应及预后情况的影响。结果术前,两组患者cTnⅠ、CK-MB水平无差异(P>0.05);术后24h,两组患者的cTnⅠ、CK-MB水平高于术前,试验组小于对照组(P<0.05)。术后24h,试验组CI水平高于对照组(P<0.05),两组患者的LVSP、LVSWⅠ、RVSWⅠ水平低于术前,试验组LVSWⅠ及RVSWⅠ指标高于对照组(P<0.05);试验组的不良反应发生率(6%)小于对照组(25.4%),差异有统计学意义(P<0.05);随访两年发现两组患者在心力衰竭、胸闷和心绞痛、再次PCI及再发心肌梗死发面无差异(P>0.05),试验组的死亡率高于对照组(P<0.05)。结论非体外循环下冠状动脉搭桥术治疗CHD能有效降低患者的不良反应发生率,减少患者的心肌损伤,同时有助于恢复患者的心功能,具有较高的推广和应用价值。Objective To investigate the clinical efficacy of off-pump coronary artery bypass grafting(OPCAB).Methods Selected the clinical data of 102 coronary heart disease(CAD)patients undergoing coronary artery bypass graft surgery in Zhengzhou the Seventh People's Hospital from October 2017 to October 2019.Patients were divided into two groups,5l patients each.The effects of different modes of surgery on myocardial,cardiac function indicators,adverse reactions and prognosis were observed.Results There were no difference in the cTnl and CK-MB levels in the two groups before surgery(P>0.05);at 24h after surgery,the cTnl and CK-MB levels were higher in both groups than before surgery,and the experimental group was lower than that in the control group(P<0.05).At 24h after surgery,the CI level of the experimental group was higher than the control group(P<0.05).The LVSP,LVSWI and RVSWI levels in both groups were lower than the preoperative levels,and the LVSWI and RVSWI indexes in the experimental group were higher than those in the control group(P<0.05);the incidence of adverse reactions in the experimental group(6%)was less than that in the control group(25.4%);the difference was statistically significant(P<0.05).After two years of follow-up,there were no difference in heart failure,chest tightness,angina pectoris,second PCI,and second myocardial infarction(P>0.05);the mortality rate in the experimental group was higher than that in the control group(P<0.05).Conclusion The OPCAB can effectively reduce the incidence of adverse reactions,reduce the myocardial injury in patients,and help to restore the cardiac function of patients,which has profound promotion and application value.

关 键 词：冠心病 动脉搭桥术 心肌损伤 

分 类 号：R543[医药卫生—心血管疾病]