冠脉介入与外科搭桥治疗冠心病的临床疗效对比  

Comparison of clinical efficacy of percutaneous coronary intervention and surgical bypass in patients with coronary heart disease

作　　者：朱逸 王岩 应良红 慧惠 朱玲玲 ZHU Yi;WANG Yan;YING Liang-hong(Department of Cardiothoracic Surgery,The Second People's Hospital of Huai'an City,Huaian Hospital Affiliated to Xuzhou Medical University,Xuzhou 223001,China)

机构地区：[1]淮安市第二人民医院,徐州医科大学附属淮安医院心胸外科,223001 [2]淮安市第二人民医院,徐州医科大学附属淮安医院心内科,223001 [3]淮安市第二人民医院,徐州医科大学附属淮安医院手术室,223001

出　　处：《中国实用医药》2025年第1期41-44,共4页China Practical Medicine

摘　　要：目的对比冠状动脉(冠脉)介入手术、外科搭桥手术治疗冠心病的临床疗效。方法选取60例冠心病患者,根据信封法分为搭桥组和介入组,每组30例。搭桥组采用外科搭桥手术治疗,介入组采用冠脉介入手术治疗。比较两组患者治疗效果、心功能指标[左室舒张末期内径(LVEDD)、左心室收缩末期容积(LVESV)、左室射血分数(LVEF)]、心血管事件发生情况、随访结局。结果搭桥组治疗总有效率(96.67%)与介入组(100.00%)比较,无明显差异(P>0.05)。手术前,搭桥组患者LVEDD为(65.87±4.78)mm,LVESV为(68.74±5.46)ml,LVEF为(40.21±3.40)%;介入组患者LVEDD为(65.34±4.71)mm,LVESV为(68.21±5.40)ml,LVEF为(40.78±3.49)%。手术1周后,搭桥组患者LVEDD为(48.23±4.31)mm,LVESV为(40.32±5.03)ml,LVEF为(52.45±3.76)%;介入组患者LVEDD为(48.76±4.39)mm,LVESV为(41.06±5.15)ml,LVEF为(52.10±3.70)%。手术1周后,两组患者LVEDD、LVESV、LVEF均优于本组手术前,差异明显(P<0.05);但两组患者LVEDD、LVESV、LVEF比较,无明显差异(P>0.05)。搭桥组心血管事件发生率为6.67%,低于介入组的26.67%,差异明显(P<0.05)。搭桥组再次住院为10.00%,死亡率为3.33%;介入组再次住院为13.33%,死亡率为3.33%。两组再次住院率、死亡率比较,无明显差异(P>0.05)。结论冠脉介入手术、外科搭桥手术对于冠心病均具有良好的治疗效果,但外科搭桥手术心血管事件发生率低,临床可根据患者需求及实际情况选择最适宜手术,有效治疗患者疾病。Objective To compared the clinical efficacy of percutaneous coronary intervention and surgical bypass in patients with coronary heart disease.Methods 60 patients with coronary heart disease were selected for study.Envelope method was used to divide patients into bypass group and intervention group,each consisting of 30 cases.The bypass group was treated with surgical bypass,and the intervention was treated with percutaneous coronary intervention.Comparison was made on therapeutic effect,cardiac function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF)],occurrence of cardiovascular events and follow-up outcomes between the two groups.Results There was no significant difference in total effective rate of treatment between the bypass group(96.67%)and the intervention group(100.00%)(P>0.05).Before surgery,the bypass group had an LVEDD of(65.87±4.78)mm,an LVESV of(68.74±5.46)ml,and an LVEF of(40.21±3.40)%;the intervention group had an LVEDD of(65.34±4.71)mm,an LVESV of(68.21±5.40)ml,and an LVEF of(40.78±3.49)%.After 1 week of surgery,the bypass group had an LVEDD of(48.23±4.31)mm,an LVESV of(40.32±5.03)ml,and an LVEF of(52.45±3.76)%;the intervention group had an LVEDD of(48.76±4.39)mm,an LVESV of(41.06±5.15)ml and an LVEF of(52.10±3.70)%.1 week after surgery,LVEDD,LVESV and LVEF in both groups were better than those before surgery,and there were significant differences(P<0.05).But there was no significant difference in LVEDD,LVESV and LVEF between the two groups(P>0.05).The incidence of cardiovascular events in the bypass group was 6.67%,which was lower than 26.67%in the intervention group(P<0.05).In the bypass group,the re-hospitalization rate was 10.00%and the mortality rate was 3.33%;in the intervention group,the re-hospitalization rate was 13.33%and the mortality rate was 3.33%.There were no significant difference in rehospitalization rate and mortality rate between the two groups(P>0.05).Conclusion Both percutan

关 键 词：冠心病 冠状动脉介入手术 外科搭桥手术 手术效果 随访结局 心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]