非体外循环与体外循环CABG治疗冠心病的临床价值及对预后的影响  

Clinical value of non-corporeal versus extracorporeal CABG in the treatment of coronary artery disease and the impact on prognosis

作　　者：赵博 梁飞 贾磊强 Zhao Bo;Liang Fei;Jia Lei-qiang(Department of Cardiac Vascular Surgery,The Second People's Hospital of Nanyang City,Nanyang 473100,Henan,China)

机构地区：[1]南阳市第二人民医院心脏大血管外科,河南南阳473100

出　　处：《四川生理科学杂志》2025年第2期442-445,共4页

摘　　要：目的:探究非体外循环与体外循环冠状动脉旁路移植术(CABG)治疗冠心病的临床价值及对预后状况、术后并发症影响。方法:回顾性收集2021.9-2024.1期间本院收治的113例冠心病患者的临床资料。依据不同治疗方法将患者分为体外组(行体外循环冠状动脉旁路移植术,n=54)和非体外组(非体外循环冠状动脉旁路移植术,n=59)。分析比较两组的围手术期指标、心肌功能[心脏指数(CI)、心肌肌钙蛋白(cTnI)、左心室射血分数(LVEF)、肌酸激酶同工酶(CK-MB)]、生化指标[γ-谷氨酰转移酶(GGT)、白细胞介素-8(IL-8)、同型半胱氨酸(HCY)、低密度脂蛋白(LDL)]、生活质量以及并发症。结果:非体外组的医疗费用、手术时间、术后ICU入住时间、住院时间、术后机械通气时间、出血量均比体外组显著降低(P<0.05)。术后1m,非体外组的血清cTnI、CK-MB水平均显著低于体外组,CI、LVEF指标均显著高于体外组(P<0.05)。与体外组相比,术后1m,非体外组的血清GGT、HCY、IL-8、LDL水平均显著降低(P<0.05)。与体外组相比,术后1m,非体外组生活质量评分显著提高(P<0.05)。两组的并发症发生率无显著差异(P>0.05)。结论:非体外循环冠状动脉旁路移植术治疗能改善患者的围术期指标,促进术后康复,改善冠心病患者心肌功能,改善生化指标,提高术后生活质量,且安全性较好。Objective:To investigate the clinical value of off-pump and extracorporeal circulation coronary artery bypass grafting(CABG)in the treatment of coronary heart disease and its influence on prognosis and postoperative complications.Methods:The clinical data of 113 patients with coronary heart disease(CHD)admitted to our hospital during 2021.9 to 2024.1 were retrospectively collected.According to different treatment methods,the patients were divided into vitro group(CPG,n=54)and non-extracorporeal group(CPG,n=59).Perioperative indexes,myocardial function[heart index(CI),myocardial troponin(cTnI),left ventricular ejection fraction(LVEF),creatine kinase isoenzyme(CK-MB)],biochemical indexes[gamma-glutamyltransferase(GGT),interleukin-8(IL-8),homocysteine(HCY),and low density lipid protein(LDL)],quality of life,and complications of the two groups were analyzed and compared.Results:The medical cost,operation time,ICU stay time,hospital stay,postoperative mechanical ventilation time and blood loss in the non-vitro group were significantly lower than those in the vitro group(P<0.05).One month after surgery,the levels of serum cTnl and CK-MB in non-vitro group were significantly lower than those in vitro group,and the indexes of CI and LVEF were significantly higher than those in vitro group(P<0.05).Compared with the in vitro group,the serum GGT,HCY,IL-8 and LDL levels in the non-vitro group were significantly decreased one month after surgery(P<0.05).Compared with the in vitro group,the life quality score of the non-in vitro group was significantly increased one month after surgery(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Off-pump coronary artery bypass grafting can improve perioperative indexes,promote postoperative rehabilitation,improve myocardial function,improve biochemical indexes,and improve postoperative quality of life in patients with coronary heart disease,with good safety.

关 键 词：冠状动脉旁路移植术 并发症 心肌肌钙蛋白 生活质量 非体外循环 

分 类 号：R541.4[医药卫生—心血管疾病]