冠状动脉搭桥术治疗冠心病合并糖尿病患者的应用效果分析  

Application effect of coronary artery bypass grafting in patients with coronary heart disease combined with diabetes mellitus

作　　者：常浩 杜容宇 赵一帆 贺秀华 吴帆 Chang Hao;Du Rongyu;Zhao Yifan;He Xiuhua;Wu Fan(Xuchang Central Hospital,Xuchang 461000,Henan,China)

机构地区：[1]许昌市中心医院,河南许昌461000

出　　处：《临床心身疾病杂志》2025年第2期14-18,共5页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20191388)。

摘　　要：目的分析冠状动脉搭桥术(CABG)在冠心病(CHD)合并糖尿病(DM)患者中的应用效果。方法将118例CHD合并DM患者按照血运重建手术类型,分为CABG组59例和经皮冠状动脉介入治疗(PCI)组59例。记录并比较两组患者围手术期指标、心功能[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、不良事件发生情况及生活质量[采用简明健康生活质量调查表(SF-36)评估]。结果PCI组患者手术时间、住院时间、手术后呼吸机使用时间短于CABG组(P<0.01)。手术后6个月,两组患者LVEF较手术前升高,LVESD、LVEDD较手术前降低(P<0.01)。随访1 a,CABG组患者不良事件发生率低于PCI组(P<0.05)。随访1 a,两组患者SF-36总分及各维度评分较手术前升高,且CABG组高于PCI组(P<0.01)。结论CABG治疗CHD合并DM的患者疗效显著,值得临床推广。Objective To analyze the application effect of coronary ar tery bypass grafting(CABG)in patients with coronary hear t disease(CHD)combined with diabetes mellitus(DM).Methods A total of 118 patients with CHD combined with DM were divided into CABG and PCI(percutaneous coronary intervention)group according to the types of revascularization surgery,with 59 ones in each.Perioperative indicators,cardiac functions(left ventricular ejection fraction[LVEF],left ventricular end-systolic diameter[LVESD],and left ventricular end-diastolic diameter[LVEDD]),the occurrence of adverse events,and quality of life(The MOS 36-Item Short-Form Health Survey[SF-36]score)of two groups were recorded and compared.Results Operation time,hospital length of stay,and duration of postoperative mechanical ventilation were shorter in PCI than CABG group(P<0.01).Six months after surgery,LVEFs elevated and LVEDDs and LVESDs lowered in both groups compared with preoperation(P<0.01).After 1 year follow-up,the incidence of adverse events was lower in CABG than PCI group(P<0.05).After 1 year follow-up,the total and each dimension scores of the SF-36 elevated in both groups compared with pre-operation,and those were higher in CABG than PCI group(P<0.01).Conclusion The CABG is effective in patients with CHD combined with DM and deserves clinical promotion.

关 键 词：冠心病 糖尿病 非体外循冠状动脉搭桥术 生活质量 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]